MEDICARE: LIFE HEALTH CARE 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	3104A0630X	Assisted Living Facility (Behavioral Disturbances)

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

General Provider Information

NPI Number	:	1902576465
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE HEALTH CARE INC

Provider Business Mailing Address
First Line	:	499 SW HURTIG CT
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34983-2977
Country	:	US
Telephone Number	:	561-215-1038
Fax Number	:

Provider Business Practice Location Address
First Line	:	499 SW HURTIG CT
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34983-2977
Country	:	US
Telephone Number	:	561-215-1038
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. MIRLANDE MONPLAISIR
Credential	:
Telephone Number	:	561-215-1038

Provider Enumeration Date	:	09/16/2021
Last Update Date	:	09/12/2024

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Directions to “LIFE HEALTH CARE INC ” Practice Location

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