Provider Demographics
NPI:1780483701
Name:LYFCARE HOMES
Entity type:Organization
Organization Name:LYFCARE HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LATIFAT
Authorized Official - Middle Name:
Authorized Official - Last Name:ATANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-279-9085
Mailing Address - Street 1:3002 HARMON RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-4476
Mailing Address - Country:US
Mailing Address - Phone:469-279-9085
Mailing Address - Fax:469-279-9085
Practice Address - Street 1:3002 HARMON RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-4476
Practice Address - Country:US
Practice Address - Phone:469-279-9085
Practice Address - Fax:469-279-9085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities