MEDICARE: LA HOME CARE

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	:	1922874692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LA HOME CARE

Provider Business Mailing Address
First Line	:	34 TALL PINES DR APT 7
Second Line	:
City	:	LEWISTON
State	:	ME
Zip	:	04240-3280
Country	:	US
Telephone Number	:	207-440-9276
Fax Number	:

Provider Business Practice Location Address
First Line	:	34 TALL PINES DR APT 7
Second Line	:
City	:	LEWISTON
State	:	ME
Zip	:	04240-3280
Country	:	US
Telephone Number	:	207-440-9276
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	NAJMA Y MOHAMED
Credential	:
Telephone Number	:	207-440-9276

Provider Enumeration Date	:	12/04/2023
Last Update Date	:	12/04/2023

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Directions to “LA HOME CARE ” Practice Location

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