Basic Information
| Provider Information | |||||||||
| NPI: | 1861492332 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LIFEPATH HOME HEALTH CARE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 491 WILLIAMSON ROAD, | ||||||||
| Address2: | SUITE 204 | ||||||||
| City: | MOORESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281179252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7046642876 | ||||||||
| FaxNumber: | 8012639929 | ||||||||
| Practice Location | |||||||||
| Address1: | 5801 FASHION BLVD. | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841076159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8012930444 | ||||||||
| FaxNumber: | 8012639929 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2005 | ||||||||
| LastUpdateDate: | 08/29/2012 | ||||||||
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| AuthorizedOfficialLastName: | ABELL | ||||||||
| AuthorizedOfficialFirstName: | DOUGLAS | ||||||||
| AuthorizedOfficialMiddleName: | J. | ||||||||
| AuthorizedOfficialTitleorPosition: | SECRETARY AND GENERAL COUNSEL | ||||||||
| AuthorizedOfficialTelephone: | 7046642876 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | 002902 | UT | Y | Agencies | Home Health |
No ID Information.