MEDICARE: LIFE STYLES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency		AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104895820
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE STYLES INC.

Provider Business Mailing Address
First Line	:	2471 W SYCAMORE ST
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72703-1140
Country	:	US
Telephone Number	:	479-521-3581
Fax Number	:	479-695-1778

Provider Business Practice Location Address
First Line	:	2471 W SYCAMORE ST
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72703-1140
Country	:	US
Telephone Number	:	479-521-3581
Fax Number	:	479-695-1778

Authorized Official
Title or Position	:	FINANCE DIRECTOR
Name	:	MRS. SHERRY L ANDERSON
Credential	:
Telephone Number	:	479-521-3581

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	12/17/2020

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Directions to “LIFE STYLES INC. ” Practice Location

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