Healthcare Provider Details

I. General information

NPI: 1073275970
Provider Name (Legal Business Name): LAURA'S LIGHT HHC/TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2021
Last Update Date: 10/07/2021
Certification Date: 10/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HAYES
IRVINE CA
92620-3747
US

IV. Provider business mailing address

400 HAYES
IRVINE CA
92620-3747
US

V. Phone/Fax

Practice location:
  • Phone: 657-210-0465
  • Fax:
Mailing address:
  • Phone: 657-210-0465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MRS. FELICIA ULMER
Title or Position: CEO
Credential: RN
Phone: 949-414-6628