MEDICARE: LJC 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

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	:	1982073904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LJC HOME CARE, LLC

Provider Business Mailing Address
First Line	:	9 N 3RD ST
Second Line	:
City	:	NEWARK
State	:	OH
Zip	:	43055-5506
Country	:	US
Telephone Number	:	614-495-0276
Fax Number	:	614-368-2020

Provider Business Practice Location Address
First Line	:	9 N 3RD ST
Second Line	:
City	:	NEWARK
State	:	OH
Zip	:	43055-5506
Country	:	US
Telephone Number	:	614-495-0276
Fax Number	:	614-368-2020

Authorized Official
Title or Position	:	OWNER/VICE PRESIDENT
Name	:	MARIANNE E CHRISTMAN
Credential	:
Telephone Number	:	614-495-0276

Provider Enumeration Date	:	09/21/2015
Last Update Date	:	01/15/2020

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Directions to “LJC HOME CARE, LLC ” Practice Location

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