Healthcare Provider Details

I. General information

NPI: 1891584553
Provider Name (Legal Business Name): LYFTYM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E BELT LINE RD
CARROLLTON TX
75006-6307
US

IV. Provider business mailing address

1500 E BELT LINE RD
CARROLLTON TX
75006-6307
US

V. Phone/Fax

Practice location:
  • Phone: 214-554-5385
  • Fax:
Mailing address:
  • Phone: 763-227-2503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: EVANS OKORO
Title or Position: OWNER
Credential:
Phone: 214-554-5385