Lifeway Healthcare Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

010788 Issued in TX

Legal business name

LIFEWAY HEALTHCARE INC

Practice address

10039 Bissonnet Street # 112
Houston, TX 77036

Phone

(281) 495-5100

Fax

(281) 495-5101

NPI assigned

Oct 24, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Airoboman Omoegbele, REGISTERED NURSE

Title

Administrator

Phone

(281) 495-5100

Specialties & licenses 1

Addresses

Other names 1

• D/B/A Lifeway Healthcare Inc Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Home health agency certification: CCN 743133

Legal name

LIFEWAY HEALTHCARE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 14, 2008

Last certification

Feb 7, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

May 9, 2006 in TX

Enrollment address

10039 Bissonnet Street
Suite 112
Houston, TX 77036-9963

Listed as

Lifeway Healthcare IncCCN 743133

Ownership

Proprietary

Certified

Jun 14, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Physical therapy, Speech pathology, Occupational therapy

Locations

All disclosed owners & managing parties 1

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

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626739200000",
    "number": "1700960101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10039 BISSONNET STREET # 112",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77036",
            "telephone_number": "281-495-5100",
            "fax_number": "281-495-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10039 BISSONNET STREET # 112",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77036",
            "telephone_number": "281-495-5100",
            "fax_number": "281-495-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWAY HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A",
        "authorized_official_last_name": "OMOEGBELE",
        "authorized_official_first_name": "AIROBOMAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "281-495-5100",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "REGISTERED NURSE"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "010788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "D/B/A Lifeway Healthcare Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "D/B/A Lifeway Healthcare Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lifetime Homecare Services LLC
• Lifetime OBGYN PLLC
• Lifetrust Home Health & Consulting PLLC
• Lifewatch EMS LLC
• Lifeway EMS Inc
• Lifeway International Houston LLC
• Lifeworks Dental, PLLC
• Lifeworks Family Care, LLC
• Carlos Lifschitz, MD
• Stacy Lifsey

• Home Health Agency in Houston, TX
• Providers in Houston, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.