MEDICARE: LIFESTYLE HEALTH SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1558673723
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFESTYLE HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	5322 W BELLFORT ST STE 215
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77035-3039
Country	:	US
Telephone Number	:	281-741-4197
Fax Number	:

Provider Business Practice Location Address
First Line	:	5322 W BELLFORT ST STE 215
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77035-3039
Country	:	US
Telephone Number	:	281-741-4197
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	VANESSA LYN JOHNS
Credential	:	RN
Telephone Number	:	281-741-4197

Provider Enumeration Date	:	07/05/2010
Last Update Date	:	10/20/2016

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