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NPI Code Detail

MEDICARE: LIFENET SERVICES INC.

MEDICARE: LIFENET 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
1251S00000XCommunity/Behavioral Health Agency
2251S00000XCommunity/Behavioral Health Agency1887-ATX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A099677OTHERTXNORTHSTAR VENDOR NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952474017
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFENET SERVICES INC.
Provider Business Mailing Address
First Line : 9708 SKILLMAN STREET
Second Line :
City : DALLAS
State : TX
Zip : 75243-5150
Country : US
Telephone Number : 214-221-5433
Fax Number : 214-932-1977
Provider Business Practice Location Address
First Line : 9708 SKILLMAN STREET
Second Line :
City : DALLAS
State : TX
Zip : 75243-5150
Country : US
Telephone Number : 214-221-5433
Fax Number : 214-932-1977
Authorized Official
Title or Position : CFO
Name : MR. BOB ROBERTSON
Credential :
Telephone Number : 214-221-5433
Provider Enumeration Date : 11/16/2006
Last Update Date : 11/20/2013

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Directions to “LIFENET SERVICES INC. ” Practice Location

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