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General NPI Number Information
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NPI Number | 1760298715
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Entity Type | Organization
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Legal Business Name | LIFE ASSIST HOME CARE LLC
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 205 COTTON VIEW LN
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City | RED OAK
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State | TX
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Zip | 75154-2728
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Country | US
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Telephone | 469-337-2150
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Fax |
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Provider Business Mailing Address
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Address Line | 205 COTTON VIEW LN
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City | RED OAK
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State | TX
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Zip | 75154-2728
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Country | US
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Telephone | 469-337-2150
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Fax |
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | COURTNEY DERRELL AIKENS
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Credential | R.PH
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Telephone | 469-337-2150
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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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