Healthcare Provider Details
I. General information
NPI: 1174863583
Provider Name (Legal Business Name): LHCG XXXVIII, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/21/2013
Last Update Date: 02/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2375 CHICAGO AVE
RIVERSIDE CA
92507-6902
US
IV. Provider business mailing address
PO BOX 51266
LAFAYETTE LA
70505-1266
US
V. Phone/Fax
- Phone: 951-774-3023
- Fax: 951-774-3027
- Phone: 337-233-1307
- Fax: 337-233-5764
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DONALD
D.
STELLY
Title or Position: PRESIDENT
Credential:
Phone: 337-233-1307