Provider Demographics
NPI:1720869274
Name:LIFESTYLE AND WELLNESS HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:LIFESTYLE AND WELLNESS HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:GARGALLO
Authorized Official - Last Name:BUFETE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-649-6060
Mailing Address - Street 1:16 CORNING AVE STE 176
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-5343
Mailing Address - Country:US
Mailing Address - Phone:408-649-6060
Mailing Address - Fax:800-757-0971
Practice Address - Street 1:16 CORNING AVE STE 176
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-5343
Practice Address - Country:US
Practice Address - Phone:408-649-6060
Practice Address - Fax:800-757-0971
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH CARE AND SERVICE INDUSTRIES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health