MEDICARE: LIFE SOLUTION HEALTHCARE SERVICES

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C4824309	OTHER	CA	ARTICLES OF INCORPORATION

General Provider Information

NPI Number	:	1467104935
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE SOLUTION HEALTHCARE SERVICES

Provider Business Mailing Address
First Line	:	9550 WARNER AVE STE 250-20
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-2800
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9550 WARNER AVE STE 250-20
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-2800
Country	:	US
Telephone Number	:	678-857-2179
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	EUGENE STA ANA
Credential	:
Telephone Number	:	678-857-2179

Provider Enumeration Date	:	01/25/2022
Last Update Date	:	01/25/2022

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Directions to “LIFE SOLUTION HEALTHCARE SERVICES ” Practice Location

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