Healthcare Provider Details
I. General information
NPI: 1639957210
Provider Name (Legal Business Name): LIFESTYLE HOMECARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/15/2023
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 LAFAYETTE BLVD STE 1113
BRIDGEPORT CT
06604-4725
US
IV. Provider business mailing address
4240 HUTCHINSON RIVER PKWY E APT 8E
BRONX NY
10475-4762
US
V. Phone/Fax
- Phone: 475-374-0966
- Fax: 914-206-3605
- Phone: 646-341-7494
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SAMUEL
APPIAH
Title or Position: CEO
Credential:
Phone: 646-341-7494