MEDICARE: LUMIWELL HOME CARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	385H00000X	Respite Care
3	311ZA0620X	Adult Care Home Facility
4	251C00000X	Developmentally Disabled Services Day Training Agency
5	315P00000X	Intellectual Disabilities Intermediate Care Facility
6	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1487464970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUMIWELL HOME CARE LLC

Provider Business Mailing Address
First Line	:	5108 E CLINTON WAY STE 107
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93727-2043
Country	:	US
Telephone Number	:	559-318-5004
Fax Number	:	559-520-4819

Provider Business Practice Location Address
First Line	:	5108 E CLINTON WAY STE 107
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93727-2043
Country	:	US
Telephone Number	:	559-318-5004
Fax Number	:	559-520-4819

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	PA VUE
Credential	:	RN
Telephone Number	:	559-478-3736

Provider Enumeration Date	:	01/08/2025
Last Update Date	:	02/16/2026

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