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General NPI Number Information
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NPI Number | 1871885517
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Entity Type | Organization
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Legal Business Name | LIFETIME HEALTHCARE INCORPORATED
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Dates
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Enumeration Date | 05/13/2011
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Last Update Date | 05/13/2011
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Provider Practice Location Address
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Address Line | 2201 ROBINSON DR
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City | MOBILE
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State | AL
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Zip | 36605-5137
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Country | US
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Telephone | 251-648-4893
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Fax | 251-473-9868
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Provider Business Mailing Address
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Address Line | 2201 ROBINSON DR
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City | MOBILE
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State | AL
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Zip | 36605-5137
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Country | US
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Telephone | 251-648-4893
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Fax | 251-473-9868
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN MALONE SMITH
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Credential |
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Telephone | 251-648-4893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State | AL
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