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General NPI Number Information
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NPI Number | 1033367453
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Entity Type | Organization
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Legal Business Name | LUTHERAN HAVEN HOME HEALTHCARE LLC C/O LUTHERAN HAVEN INC SOLE MBR
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Dates
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Enumeration Date | 08/28/2008
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 2041 W STATE ROAD 426
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City | OVIEDO
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State | FL
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Zip | 32765-8548
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Country | US
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Telephone | 407-706-1173
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Fax | 407-366-0128
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Provider Business Mailing Address
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Address Line | 2041 W STATE ROAD 426
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City | OVIEDO
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State | FL
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Zip | 32765-8548
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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 | DIRECTOR OF REHABILITATION SERVICES
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Name | MR. ALEXANDER CAGUIOA GARDUQUE
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Credential | RPT
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Telephone | 407-706-1173
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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 | HHA299993190
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License Number State | FL
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