Provider Demographics
NPI:1780369165
Name:LIFE PRINCIPLES HOMECARE AGENCY, LLC
Entity type:Organization
Organization Name:LIFE PRINCIPLES HOMECARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHANTA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-428-8053
Mailing Address - Street 1:1814 NIXON ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-4332
Mailing Address - Country:US
Mailing Address - Phone:919-428-8053
Mailing Address - Fax:919-213-7517
Practice Address - Street 1:2600 CARVER ST STE C
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2795
Practice Address - Country:US
Practice Address - Phone:919-479-9054
Practice Address - Fax:919-213-7517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-21
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty