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General NPI Number Information
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NPI Number | 1104636471
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Entity Type | Organization
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Legal Business Name | LIFORA HEALTH LLC
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Dates
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Enumeration Date | 01/09/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 13100 NOEL RD APT 308
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City | DALLAS
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State | TX
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Zip | 75240-0400
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Country | US
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Telephone | 813-538-8190
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Fax |
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Provider Business Mailing Address
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Address Line | 13100 NOEL RD APT 308
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City | DALLAS
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State | TX
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Zip | 75240-0400
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Country | US
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Telephone | 813-538-8190
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOVAN GLASGOW
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Credential |
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Telephone | 813-538-8190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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