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General NPI Number Information
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NPI Number | 1609167048
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Entity Type | Organization
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Legal Business Name | LIFESTAGES HEALTH AND HOME CARE, LLC
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Dates
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Enumeration Date | 04/20/2011
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Last Update Date | 04/20/2011
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Provider Practice Location Address
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Address Line | 3226 OAK PARK LN
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City | MISSOURI CITY
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State | TX
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Zip | 77459-6604
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Country | US
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Telephone | 832-722-7287
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Fax |
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Provider Business Mailing Address
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Address Line | 3226 OAK PARK LN
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City | MISSOURI CITY
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State | TX
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Zip | 77459-6604
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. JANENE D ROBERSON-MARSHALL
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Credential | MS, PA-C
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Telephone | 832-722-7287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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