MEDICARE: LABERT IN HOME CARE SUPPORT SERVICES

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1194980813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LABERT IN HOME CARE SUPPORT SERVICES

Provider Business Mailing Address
First Line	:	5118 W 20TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90016-1319
Country	:	US
Telephone Number	:	323-939-2431
Fax Number	:	323-939-2431

Provider Business Practice Location Address
First Line	:	5118 W 20TH ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90016-1319
Country	:	US
Telephone Number	:	323-939-2431
Fax Number	:	323-939-2431

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MS. ELEANOR HAWKINS
Credential	:
Telephone Number	:	323-939-2431

Provider Enumeration Date	:	07/22/2008
Last Update Date	:	07/22/2008

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