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Organization
LIFEVANTAGE HOME HEALTH, LLC
Active
Organization
LIFEVANTAGE HOME HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERSON PINOTE CONSERMAN (OWNER)
(817) 541-4153
Entity
Organization
Contact information
Practice address
110 SW THOMAS ST, BURLESON, TX 76028-3818
(817) 541-4153
Mailing address
110 SW THOMAS ST, BURLESON, TX 76028-3818
(817) 541-4153
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
11/10/2014
Last updated
11/10/2014
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