Healthcare Provider Details

I. General information

NPI: 1215343652
Provider Name (Legal Business Name): LHCG LVIII, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2014
Last Update Date: 07/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 STEVENS ST SUITE 4
EAST TAUNTON MA
02718-1319
US

IV. Provider business mailing address

PO BOX 51266
LAFAYETTE LA
70505-1266
US

V. Phone/Fax

Practice location:
  • Phone: 508-822-6066
  • Fax: 508-822-9820
Mailing address:
  • Phone: 337-233-1307
  • Fax: 337-233-5764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DONALD D STELLY
Title or Position: PRESIDENT, LHC GROUP, INC.
Credential:
Phone: 337-233-1307