Healthcare Provider Details
I. General information
NPI: 1588112239
Provider Name (Legal Business Name): LHCG LXXVIII, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/12/2016
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1322 ELTON RD SUITE B
JENNINGS LA
70546-4100
US
IV. Provider business mailing address
PO BOX 51266
LAFAYETTE LA
70505-1266
US
V. Phone/Fax
- Phone: 337-824-1188
- Fax: 337-824-7007
- 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