Organization
LIFECARE HOME HEALTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BOLADEMI ADETOLA RN (ADMINISTRATOR)
(310) 539-6889
Entity
Organization
Contact information
Practice address
24404 VERMONT AVE, SUITE 206, HARBOR CITY, CA 90710-2313
(310) 539-6889
(310) 517-0171
Mailing address
24404 VERMONT AVE, SUITE 206, HARBOR CITY, CA 90710-2313
(310) 539-6889
(310) 517-0171
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
550001351
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000285452
CITY OF LOS ANGELES
CA
01
—
059313
NGS-MEDICARE
CA
Enumeration date
04/22/2009
Last updated
12/06/2011
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