Healthcare Provider Details

I. General information

NPI: 1114390556
Provider Name (Legal Business Name): LSR HOMECARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2015
Last Update Date: 11/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 N MCCORD RD APT 107
TOLEDO OH
43615-3059
US

IV. Provider business mailing address

PO BOX 352003
TOLEDO OH
43635-2003
US

V. Phone/Fax

Practice location:
  • Phone: 419-279-7009
  • Fax:
Mailing address:
  • Phone:
  • 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: MS. LASHEKA JANEICE DIGGS
Title or Position: OWNER
Credential:
Phone: 419-279-7009