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General NPI Number Information
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NPI Number | 1821596289
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Entity Type | Organization
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Legal Business Name | LIFE GATE HEALTHCARE SERVICES INC
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Dates
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Enumeration Date | 01/30/2018
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Last Update Date | 12/14/2022
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Provider Practice Location Address
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Address Line | 90 PAINTERS MILL RD STE 131
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City | OWINGS MILLS
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State | MD
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Zip | 21117-3610
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Country | US
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Telephone | 443-824-0851
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Fax | 443-660-7738
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Provider Business Mailing Address
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Address Line | 90 PAINTERS MILL RD STE 131
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City | OWINGS MILLS
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State | MD
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Zip | 21117-3610
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Country | US
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Telephone | 443-870-0272
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Fax | 443-660-7738
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Authorized Official
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Title or Position | ED
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Name | MRS. BOLA OLADUNNI
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Credential | ED
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Telephone | 443-824-0851
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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