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General NPI Number Information
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NPI Number | 1144504176
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Entity Type | Organization
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Legal Business Name | LDB HEALTH SYSTEMS LLC
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Dates
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Enumeration Date | 10/10/2011
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Last Update Date | 10/10/2011
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Provider Practice Location Address
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Address Line | 450 MORTHLAND DR
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City | VALPARAISO
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State | IN
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Zip | 46383-5461
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Country | US
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Telephone | 219-299-2319
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Fax |
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Provider Business Mailing Address
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Address Line | 450 MORTHLAND DR
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City | VALPARAISO
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State | IN
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Zip | 46383-5461
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Country | US
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Telephone | 219-299-2319
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. RICHARD M LIJANA
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Credential |
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Telephone | 219-299-2319
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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 | 11-012679-1
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License Number State | IN
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