Healthcare Provider Details

I. General information

NPI: 1366783912
Provider Name (Legal Business Name): LUMEN CHRISTI HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2013
Last Update Date: 04/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7614 GREEN WILLOW CT
HYATTSVILLE MD
20785
US

IV. Provider business mailing address

7614 GREEN WILLOW CT
HYATTSVILLE MD
20785
US

V. Phone/Fax

Practice location:
  • Phone: 404-822-2004
  • Fax:
Mailing address:
  • Phone: 404-822-2004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. MIRBLE FORETIA
Title or Position: ADMINISTRATOR
Credential:
Phone: 404-822-2004