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General NPI Number Information
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NPI Number | 1013463306
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Entity Type | Organization
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Legal Business Name | LAKE ARROWHEAD HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 03/29/2018
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Provider Practice Location Address
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Address Line | 28200 HIGHWAY 189 # F240-6
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City | LAKE ARROWHEAD
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State | CA
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Zip | 92352-9700
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Country | US
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Telephone | 909-337-5655
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Fax | 909-744-9120
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Provider Business Mailing Address
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Address Line | PO BOX 1417
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City | LAKE ARROWHEAD
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State | CA
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Zip | 92352-1417
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO/ADMINISTRATOR
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Name | MS. LISA JAMES
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Credential |
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Telephone | 909-337-5655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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