MEDICARE: MRS. LASCHELLE GEORGE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide	401869890616	OH
2	3747P1801X	Personal Care Attendant		OH

General Provider Information

NPI Number	:	1144756156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LASCHELLE GEORGE

Provider Business Mailing Address
First Line	:	8164 BRIGDEN RD
Second Line	:
City	:	NORTH BLOOMFIELD
State	:	OH
Zip	:	44450-9712
Country	:	US
Telephone Number	:	330-406-6324
Fax Number	:

Provider Business Practice Location Address
First Line	:	8164 BRIGDEN RD
Second Line	:
City	:	NORTH BLOOMFIELD
State	:	OH
Zip	:	44450-9712
Country	:	US
Telephone Number	:	330-406-6324
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	11/10/2020

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Directions to “ MRS. LASCHELLE GEORGE ” Practice Location

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