Provider Demographics
NPI:1275229304
Name:LIFETIME HEALTHCARE SYSTEMS INC
Entity type:Organization
Organization Name:LIFETIME HEALTHCARE SYSTEMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:TAWADROUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-660-2389
Mailing Address - Street 1:1027 S CENTRAL AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-3973
Mailing Address - Country:US
Mailing Address - Phone:909-660-2389
Mailing Address - Fax:
Practice Address - Street 1:1027 S CENTRAL AVE STE 300
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-3973
Practice Address - Country:US
Practice Address - Phone:909-660-2389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-12
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health