Provider Demographics
NPI:1811664683
Name:LIFE ELDERCARE, INC.
Entity type:Organization
Organization Name:LIFE ELDERCARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSAGE
Authorized Official - Suffix:
Authorized Official - Credentials:ED
Authorized Official - Phone:510-314-6365
Mailing Address - Street 1:39055 HASTINGS ST STE 208
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1598
Mailing Address - Country:US
Mailing Address - Phone:510-894-0370
Mailing Address - Fax:
Practice Address - Street 1:39055 HASTINGS ST STE 208
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1598
Practice Address - Country:US
Practice Address - Phone:510-894-0370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-27
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332U00000XSuppliersHome Delivered Meals
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No174200000XOther Service ProvidersMeals
No251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
No251V00000XAgenciesVoluntary or Charitable
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)