Organization
LIFESTYLE CARE AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUPERIA INGALLS (OWNER / VICE PRESIDENT)
(856) 266-3582
Entity
Organization
Contact information
Practice address
200 BARR HARBOR DR STE 400, CONSHOHOCKEN, PA 19428-2978
(610) 572-3565
Mailing address
200 BARR HARBOR DR STE 400, CONSHOHOCKEN, PA 19428-2978
(610) 572-3565
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
07/30/2020
Last updated
07/30/2020
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