Healthcare Provider Details

I. General information

NPI: 1841452570
Provider Name (Legal Business Name): AL LIFESTYLES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 32ND ST W SUITE E31
BRADENTON FL
34205-2700
US

IV. Provider business mailing address

4301 32ND ST W SUITE E31
BRADENTON FL
34205-2700
US

V. Phone/Fax

Practice location:
  • Phone: 941-782-0823
  • Fax:
Mailing address:
  • Phone: 941-782-0823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. DOROTHY SANDHOFF
Title or Position: ADMINISTRATOR/NURSE REGISTRY
Credential: L.P.N.
Phone: 941-782-0823