Healthcare Provider Details

I. General information

NPI: 1265151427
Provider Name (Legal Business Name): LUCENT HEALTH GROUP LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2022
Last Update Date: 08/23/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 W PLANO PKWY
PLANO TX
75075-8624
US

IV. Provider business mailing address

1101 W PLANO PKWY
PLANO TX
75075-8624
US

V. Phone/Fax

Practice location:
  • Phone: 908-370-1849
  • Fax:
Mailing address:
  • Phone: 908-370-1849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: DANIEL LIVOLSI
Title or Position: MANAGING PARTNER
Credential:
Phone: 908-370-1849