Healthcare Provider Details

I. General information

NPI: 1891444808
Provider Name (Legal Business Name): LIFECARE HOMEHEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2022
Last Update Date: 04/20/2022
Certification Date: 04/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3455 N BELT LINE RD STE 205
IRVING TX
75062-7861
US

IV. Provider business mailing address

3455 N BELT LINE RD STE 205
IRVING TX
75062-7861
US

V. Phone/Fax

Practice location:
  • Phone: 469-719-5133
  • Fax: 972-570-2221
Mailing address:
  • Phone: 469-719-5133
  • Fax: 972-570-2221

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 Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: PREM ADHIKARI
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 940-594-8910