Organization Active NPI

Treasure Life Healthcare Services, Inc.

  • Home Health Agency
  • Dallas, TX
National Provider Identifier
1689785289
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
009299 Issued in TX
Legal business name
TREASURE LIFE HEALTHCARE SERVICES, INC.
Doing business as
Treasure Life Healthcare Services Inc
Practice address
8111 LBJ Fwy Ste 1330a
Dallas, TX 75251-1313
Phone
(214) 484-6084
Fax
(214) 484-6554
NPI assigned
Aug 31, 2006
Last updated
Aug 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Prince V Samuel
Title
Alternate Administrator
Phone
(214) 484-6084

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 009299 TX Primary

Addresses

Primary practice location

8111 LBJ Fwy Ste 1330a
Dallas, TX 75251-1313

Mailing address

8111 LBJ Fwy Ste 1330a
Dallas, TX 75251-1313
Phone (214) 484-6084

Other names 1

  • Treasure Life Healthcare Services Inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041111001071 TX Part A Provider - Home Health Agency 2567426364 Practice locations: Dallas, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689785289. Details of each certification follow.

Home health agency certification: CCN 457905

Legal name
TREASURE LIFE HEALTHCARE SERVICES INC
Doing business as
LIFELINE HEALTH CARE OF LINCARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 25, 2005
Last certification
Nov 15, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Apr 19, 2004 in TX
Enrollment address
8111 LBJ Fwy
Ste 1330a
Dallas, TX 75251-1313

Care Compare: Home health agency

Medicare Care Compare
Listed as
Treasure Life Healthcare Services IncorporatedCCN 457905 · All quality measures
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Oct 25, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

8111 LBJ
Ste 1330A
Dallas, TX 75251
Phone (214) 484-6084

8111 LBJ
Ste 1340A
Dallas, TX 75251

2306 Guthrie Rd
Ste 280
Garland, TX 75043
Phone (214) 484-6084

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Stacey M Murphy Individual W-2 Managing Employee Nov 14, 2012
Mercy Mbride Individual Corporate OfficerDon/Administrator Jun 6, 2012 100%
W-2 Managing EmployeeDon/Administrator Apr 19, 2004 100%
Iyakinoabasi Mbride Individual Corporate Director Nov 11, 2004
Valsamma Thomas Individual W-2 Managing EmployeeAdministrator Dec 1, 2019 100%
Ofonime a Daniel Individual Corporate Director Nov 29, 2004
W-2 Managing Employee Apr 19, 1961
Thomas George Individual Corporate Director Dec 1, 2019 100%
W-2 Managing Employee Dec 1, 2019 100%
Prince V Samuel Individual 5% Or Greater Direct Ownership Interest Dec 1, 2019 50%
Corporate DirectorPresident Dec 1, 2019 100%
W-2 Managing EmployeeAlternate Admin Dec 1, 2019
Jennie Oommen Individual 5% Or Greater Direct Ownership Interest Jun 6, 2012 1%
Corporate OfficerShareholder/Director Jun 6, 2012 25%
Corporate Director50 Shareholder Jun 6, 2012 25%
W-2 Managing EmployeeOffice Management Jun 6, 2012 25%
Latha Raju Individual 5% Or Greater Direct Ownership InterestDelete Ownership Dec 1, 2019
Corporate OfficerAlt. Director of Nursing Jun 6, 2012 100%
Corporate DirectorBoard Member Jun 6, 2012 50%
W-2 Managing Employee Dec 1, 2019 100%
Mary Ajose Individual Corporate Officer Dec 1, 2019
Corporate Director Dec 1, 2019
W-2 Managing EmployeeAlternate Supervising Nurse Dec 1, 2019
Ndianabasi Mbride Individual Corporate Director Nov 29, 2004
Gregory G McCarthy Individual Corporate Officer Nov 14, 2012
W-2 Managing Employee Nov 14, 2012

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1689785289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8111 LBJ FWY STE 1330A",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752511313",
            "telephone_number": "214-484-6084",
            "fax_number": "214-484-6554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 LBJ FWY STE 1330A",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752511313",
            "telephone_number": "214-484-6084",
            "fax_number": "214-484-6554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREASURE LIFE HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "SAMUEL",
        "authorized_official_first_name": "PRINCE",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "ALTERNATE ADMINISTRATOR",
        "authorized_official_telephone_number": "214-484-6084"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "009299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Treasure Life Healthcare Services Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Treasure Life Healthcare Services Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.