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NPI Code Detail

MEDICARE: LHCG XXXIX, LLC

MEDICARE: LHCG XXXIX, LLC
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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1184962698
Entity Type Code : Organization
Provider Name (Legal Business Name) : LHCG XXXIX, LLC
Provider Business Mailing Address
First Line : PO BOX 51266
Second Line :
City : LAFAYETTE
State : LA
Zip : 70505-1266
Country : US
Telephone Number : 337-233-1307
Fax Number : 337-233-5764
Provider Business Practice Location Address
First Line : 2500 W SAHARA AVE
Second Line : SUITE 107
City : LAS VEGAS
State : NV
Zip : 89102-4367
Country : US
Telephone Number : 702-435-5030
Fax Number : 702-435-5099
Authorized Official
Title or Position : PRESIDENT
Name : DONALD D. STELLY
Credential :
Telephone Number : 337-233-1307
Provider Enumeration Date : 01/18/2013
Last Update Date : 02/28/2013

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Directions to “LHCG XXXIX, LLC ” Practice Location

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