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General NPI Number Information
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NPI Number | 1518668672
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Entity Type | Organization
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Legal Business Name | REAL LIFE HOME CARE AGENCY LLC
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Dates
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Enumeration Date | 03/15/2023
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Last Update Date | 05/11/2023
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Provider Practice Location Address
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Address Line | 2600 E SOUTH BLVD STE 238
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City | MONTGOMERY
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State | AL
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Zip | 36116-2537
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Country | US
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Telephone | 334-593-0498
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Fax | 334-593-0312
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Provider Business Mailing Address
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Address Line | 2600 E SOUTH BLVD STE 238
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City | MONTGOMERY
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State | AL
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Zip | 36116-2537
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Country | US
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Telephone | 334-593-0498
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Fax | 334-593-0312
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Authorized Official
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Title or Position | OWNER
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Name | MELANIE RENAE HARVEY
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Credential |
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Telephone | 334-207-6120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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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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