MEDICARE: LBV PARTNERS, INC

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	385H00000X	Respite Care

General Provider Information

NPI Number	:	1760759419
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LBV PARTNERS, INC

Provider Business Mailing Address
First Line	:	3216 W MANCHESTER BLVD
Second Line	:
City	:	INGLEWOOD
State	:	CA
Zip	:	90305-2320
Country	:	US
Telephone Number	:	310-422-9262
Fax Number	:

Provider Business Practice Location Address
First Line	:	3216 W MANCHESTER BLVD
Second Line	:
City	:	INGLEWOOD
State	:	CA
Zip	:	90305-2320
Country	:	US
Telephone Number	:	310-422-9262
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	VICTORIA LUCAS
Credential	:	D.C., L.AC.
Telephone Number	:	310-422-9262

Provider Enumeration Date	:	11/23/2011
Last Update Date	:	11/23/2011

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