=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922814540
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | L&A CARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/09/2024
-----------------------------------------------------
Last Update Date | 12/09/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 460 OGDEN AVE
-----------------------------------------------------
City | JERSEY CITY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07307-1021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-718-8285
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 460 OGDEN AVE
-----------------------------------------------------
City | JERSEY CITY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07307-1021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-718-8285
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | ANEENA THOMAS PUTHENPURA
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 706-461-5359
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------