Healthcare Provider Details

I. General information

NPI: 1356697809
Provider Name (Legal Business Name): J & F HEALTHY LIFESTYLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2012
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3412 BALBOA CT
GRAPEVINE TX
76092
US

IV. Provider business mailing address

2600 E SOUTHLAKE BLVD STE 120-228
SOUTHLAKE TX
76092
US

V. Phone/Fax

Practice location:
  • Phone: 817-428-2888
  • Fax:
Mailing address:
  • Phone: 817-428-2888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: FEI XIE
Title or Position: DIRECTOR/OWNER
Credential:
Phone: 817-428-2888