MEDICARE: UNIVERSAL HOME CARE SERVICE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1508377870
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSAL HOME CARE SERVICE LLC

Provider Business Mailing Address
First Line	:	213 WASHINGTON AVE
Second Line	:
City	:	MANSFIELD
State	:	LA
Zip	:	71052-2605
Country	:	US
Telephone Number	:	318-575-1040
Fax Number	:

Provider Business Practice Location Address
First Line	:	213 WASHINGTON AVE
Second Line	:
City	:	MANSFIELD
State	:	LA
Zip	:	71052-2605
Country	:	US
Telephone Number	:	318-575-1040
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	LATONYA TURNER
Credential	:
Telephone Number	:	318-575-1040

Provider Enumeration Date	:	10/13/2017
Last Update Date	:	11/01/2017

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