Healthcare Provider Details

I. General information

NPI: 1780453415
Provider Name (Legal Business Name): LIFE WITHIN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2023
Last Update Date: 12/21/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8155 CYPRESS POINT RD
WEST PALM BEACH FL
33412-2442
US

IV. Provider business mailing address

8155 CYPRESS POINT RD
WEST PALM BEACH FL
33412-2442
US

V. Phone/Fax

Practice location:
  • Phone: 773-251-0155
  • Fax:
Mailing address:
  • Phone: 773-251-0155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: LAREECE LONG
Title or Position: CEO
Credential:
Phone: 773-251-0155