MEDICARE: LIFE CHORES SERVICES LIMITED LIABILITY COMPANY

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

General Provider Information

NPI Number	:	1790475093
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE CHORES SERVICES LIMITED LIABILITY COMPANY

Provider Business Mailing Address
First Line	:	7275 MICHAEL ST
Second Line	:
City	:	TAYLOR
State	:	MI
Zip	:	48180-1521
Country	:	US
Telephone Number	:	131-392-5653
Fax Number	:

Provider Business Practice Location Address
First Line	:	4678 MERRICK ST
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48125-2860
Country	:	US
Telephone Number	:	313-925-6535
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MS. LANETRIA ANN GIBSON
Credential	:
Telephone Number	:	131-392-5653

Provider Enumeration Date	:	05/10/2023
Last Update Date	:	05/10/2023

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