MEDICARE: LEAN ON US HOME CARE 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	:	1780077974
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEAN ON US HOME CARE LLC

Provider Business Mailing Address
First Line	:	3306 STARBRIDGE PARK LN
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-8169
Country	:	US
Telephone Number	:	281-944-9127
Fax Number	:	281-944-9127

Provider Business Practice Location Address
First Line	:	9302 GAUGUIN LN
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-6918
Country	:	US
Telephone Number	:	281-944-9127
Fax Number	:	281-944-9127

Authorized Official
Title or Position	:	OWNNER
Name	:	MRS. BEATRICE ASHU
Credential	:
Telephone Number	:	281-764-9611

Provider Enumeration Date	:	03/11/2015
Last Update Date	:	03/11/2015

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