Provider Demographics
NPI:1730901117
Name:OLIVE'S LIFETIME CARE LLC
Entity type:Organization
Organization Name:OLIVE'S LIFETIME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FELECIA
Authorized Official - Middle Name:CELIA
Authorized Official - Last Name:MCINTYRE
Authorized Official - Suffix:
Authorized Official - Credentials:MGR
Authorized Official - Phone:561-856-7359
Mailing Address - Street 1:200 KNUTH RD STE 106G
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-4635
Mailing Address - Country:US
Mailing Address - Phone:561-856-7359
Mailing Address - Fax:603-306-1885
Practice Address - Street 1:200 KNUTH RD STE 106G
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-4635
Practice Address - Country:US
Practice Address - Phone:561-856-7359
Practice Address - Fax:603-306-1885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care