MEDICARE: LIFE CARE HOME HEALTH SERVICES 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	251E00000X	Home Health Agency	299991190	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10D0920904	OTHER	FL	CLIA NUMBER
2	299991190	OTHER	FL	HOME HEALTH AGENCY LICENS

General Provider Information

NPI Number	:	1386850360
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE CARE HOME HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	420 US HIGHWAY 1 STE 20
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-5552
Country	:	US
Telephone Number	:	561-845-2600
Fax Number	:	561-845-2635

Provider Business Practice Location Address
First Line	:	420 US HIGHWAY 1 STE 20
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-5552
Country	:	US
Telephone Number	:	561-845-2600
Fax Number	:	561-845-2635

Authorized Official
Title or Position	:	SENIOR DIRECTOR
Name	:	JAMES W EYER JR.
Credential	:
Telephone Number	:	561-272-5866

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	07/20/2010

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