MEDICARE: LIMA-CARE HEALTH SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1457977738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIMA-CARE HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	12066 AYESHA PARK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77099-5628
Country	:	US
Telephone Number	:	832-692-1214
Fax Number	:

Provider Business Practice Location Address
First Line	:	12066 AYESHA PARK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77099-5628
Country	:	US
Telephone Number	:	832-692-1214
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	HALIMA ISAH
Credential	:
Telephone Number	:	832-692-1214

Provider Enumeration Date	:	06/22/2020
Last Update Date	:	06/22/2020

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