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General NPI Number Information
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NPI Number | 1467456434
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Entity Type | Organization
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Legal Business Name | LUTHERAN HOME CARE AGENCY, INC.
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Dates
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Enumeration Date | 06/08/2005
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Last Update Date | 02/28/2012
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Provider Practice Location Address
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Address Line | 100 MAYER ROAD
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City | FRANKENMUTH
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State | MI
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Zip | 48734-9502
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Country | US
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Telephone | 989-652-4663
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Fax | 989-652-3279
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Provider Business Mailing Address
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Address Line | 100 MAYER ROAD
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City | FRANKENMUTH
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State | MI
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Zip | 48734-9502
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Country | US
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Telephone | 989-652-4663
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Fax | 989-652-3279
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LYNN MAURER
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Credential | RN
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Telephone | 989-652-4663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 733513
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License Number State | MI
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