MEDICARE: LOIS LANE OPERATIONS, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QR0400X	Rehabilitation Clinic/Center
2	385H00000X	Respite Care
3	314000000X	Skilled Nursing Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912331604
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOIS LANE OPERATIONS, LLC

Provider Business Mailing Address
First Line	:	26522 LA ALAMEDA STE 300
Second Line	:
City	:	MISSION VIEJO
State	:	CA
Zip	:	92691-8302
Country	:	US
Telephone Number	:	949-449-2500
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 LOIS LN
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-1320
Country	:	US
Telephone Number	:	719-635-2569
Fax Number	:	719-635-2530

Authorized Official
Title or Position	:	EXECUTIVE VICE PRESIDENT
Name	:	RACHEL SILVER
Credential	:
Telephone Number	:	619-876-9252

Provider Enumeration Date	:	08/29/2013
Last Update Date	:	02/07/2019

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Directions to “LOIS LANE OPERATIONS, LLC ” Practice Location

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