# HCA84 LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lifestar Home Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770285561
- **Authorized official:** MATT WILLARD ROGERS (MEMBER)
- **Authorized official phone:** (405) 641-7565

## Contact information

- **Practice address:** 13829 N MAY AVE, OKLAHOMA CITY, OK 73134-5010
- **Practice address phone:** (405) 286-0388
- **Practice address fax:** (405) 694-4509
- **Mailing address:** 13829 N MAY AVE, OKLAHOMA CITY, OK 73134-5010
- **Mailing address phone:** (405) 286-0388
- **Mailing address fax:** (405) 694-4509

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 03/17/2023
- **Last updated:** 03/30/2023