Healthcare Provider Details

I. General information

NPI: 1780483701
Provider Name (Legal Business Name): LYFCARE HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3002 HARMON RD
MANSFIELD TX
76063-4476
US

IV. Provider business mailing address

3002 HARMON RD
MANSFIELD TX
76063-4476
US

V. Phone/Fax

Practice location:
  • Phone: 469-279-9085
  • Fax: 469-279-9085
Mailing address:
  • Phone: 469-279-9085
  • Fax: 469-279-9085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: LATIFAT ATANDA
Title or Position: MANAGER
Credential:
Phone: 469-279-9085