Healthcare Provider Details

I. General information

NPI: 1053317735
Provider Name (Legal Business Name): LUTHERAN HOME CARE AGENCY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 02/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MAYER ROAD
FRANKENMUTH MI
48734-9502
US

IV. Provider business mailing address

100 MAYER ROAD
FRANKENMUTH MI
48734-9502
US

V. Phone/Fax

Practice location:
  • Phone: 989-652-4663
  • Fax: 989-652-3279
Mailing address:
  • Phone: 989-652-4663
  • Fax: 989-652-3279

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: LYNN MAURER
Title or Position: EXECUTIVE DIRECTOR
Credential: RN
Phone: 989-652-4663