Healthcare Provider Details

I. General information

NPI: 1417301557
Provider Name (Legal Business Name): LHCG LXXXI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2016
Last Update Date: 07/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 S EDGEWOOD ST SUITE A
BALTIMORE MD
21227-1071
US

IV. Provider business mailing address

PO BOX 51266
LAFAYETTE LA
70505-1266
US

V. Phone/Fax

Practice location:
  • Phone: 410-368-2825
  • Fax:
Mailing address:
  • Phone: 337-233-1307
  • Fax:

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
Credential:
Phone: 337-233-1307