MEDICARE: LIFELONG ADVOCACY & SUPPORT COORDINATION LLC

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

General Provider Information

NPI Number	:	1386576692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFELONG ADVOCACY & SUPPORT COORDINATION LLC

Provider Business Mailing Address
First Line	:	PO BOX 426
Second Line	:
City	:	BROOKSHIRE
State	:	TX
Zip	:	77423-0426
Country	:	US
Telephone Number	:	832-971-6062
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 EAST AVE STE D
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493-1642
Country	:	US
Telephone Number	:	832-971-6062
Fax Number	:

Authorized Official
Title or Position	:	SOLE MEMBER/MANAGER
Name	:	AVA MENEFEE
Credential	:
Telephone Number	:	832-971-6062

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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