MEDICARE: LHCG CXVI, 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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1437626710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LHCG CXVI, 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	:

Provider Business Practice Location Address
First Line	:	5253 PRUE RD STE 315D
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-1758
Country	:	US
Telephone Number	:	210-785-5200
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DONALD D. STELLY
Credential	:
Telephone Number	:	337-233-1307

Provider Enumeration Date	:	10/25/2018
Last Update Date	:	10/31/2018

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