MEDICARE: LW CARE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1801616800
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LW CARE LLC

Provider Business Mailing Address
First Line	:	2550 W UNION HILLS DR STE 350
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85027-5187
Country	:	US
Telephone Number	:	915-247-6129
Fax Number	:

Provider Business Practice Location Address
First Line	:	8880 CAL CENTER DR FL 4
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95826-3222
Country	:	US
Telephone Number	:	915-247-6129
Fax Number	:

Authorized Official
Title or Position	:	EVP
Name	:	WALTER THOMAS WHITE
Credential	:
Telephone Number	:	602-301-0610

Provider Enumeration Date	:	10/14/2024
Last Update Date	:	10/14/2024

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