Healthcare Provider Details

I. General information

NPI: 1255193496
Provider Name (Legal Business Name): LIFESTYLE SOLUTION GROUP LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 EVES DR STE 111
MARLTON NJ
08053-3125
US

IV. Provider business mailing address

1 EVES DR STE 111
MARLTON NJ
08053-3125
US

V. Phone/Fax

Practice location:
  • Phone: 267-549-9009
  • Fax:
Mailing address:
  • Phone: 267-549-9009
  • 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

VIII. Authorized Official

Name: AMIR LITTLE
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 267-549-9009