MEDICARE: LIFE CONCEPTS 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	251J00000X	Nursing Care Agency
2	251S00000X	Community/Behavioral Health Agency	1-01-0541	FL
3	251V00000X	Voluntary or Charitable Agency
4	315P00000X	Intellectual Disabilities Intermediate Care Facility
5	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
6	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
7	343900000X	Non-emergency Medical Transport (VAN)
8	347C00000X	Private Vehicle
9	385H00000X	Respite Care
10	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
11	251C00000X	Developmentally Disabled Services Day Training Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790824407
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE CONCEPTS INC

Provider Business Mailing Address
First Line	:	1509 E COLONIAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-4704
Country	:	US
Telephone Number	:	407-218-4300
Fax Number	:	407-218-4301

Provider Business Practice Location Address
First Line	:	500 E COLONIAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-4504
Country	:	US
Telephone Number	:	407-218-4300
Fax Number	:	407-218-4304

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	BROOKE EAKINS
Credential	:
Telephone Number	:	407-218-4356

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	03/09/2022

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Directions to “LIFE CONCEPTS INC ” Practice Location

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