Healthcare Provider Details

I. General information

NPI: 1790387108
Provider Name (Legal Business Name): LYFECYCLE SOLUTIONS INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2020
Last Update Date: 11/20/2020
Certification Date: 11/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46828 HOUGHTON DR
SHELBY TOWNSHIP MI
48315-5264
US

IV. Provider business mailing address

7755 22 MILE RD #182445
SHELBY TOWNSHIP MI
48318
US

V. Phone/Fax

Practice location:
  • Phone: 248-872-9376
  • Fax:
Mailing address:
  • Phone: 586-799-2666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CATHERINE MARIE BYRD
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 586-799-2666