Healthcare Provider Details

I. General information

NPI: 1558456053
Provider Name (Legal Business Name): LUTHERAN HOME CARE AGENCY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 09/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9710 JUNCTION ROAD - SUITE A
FRANKENMUTH MI
48734
US

IV. Provider business mailing address

9710 JUNCTION ROAD P. O. BOX 329
FRANKENMUTH MI
48734-0329
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: MR. MICHAEL G CORBY
Title or Position: CONTROLLER
Credential:
Phone: 989-652-3470