| Organization Name: | LIFE TIME HOME CARE SERVICES |
| NPI Number: | 1326223702 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BETTY KELLY LEE (DIRECTOR/OWENER) |
| Mailing Address: | 577 Pine Valley Dr Suite 200 Powder Springs |
| State: | GA US |
| Postal Code: | 301276629 |
| Phone Number: | 6785238082 |
| Fax Number: | 6785675246 |
| NPI Enumeration Date: | 01/04/2008 |
| NPI Last Update Date: | 01/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | 110R0225 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |