Provider Demographics
NPI:1083376222
Name:LUCINMA HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:LUCINMA HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:OBIAUKOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MOKOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-541-3420
Mailing Address - Street 1:8302 FAWN TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-3654
Mailing Address - Country:US
Mailing Address - Phone:713-541-3420
Mailing Address - Fax:
Practice Address - Street 1:8302 FAWN TERRACE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-3654
Practice Address - Country:US
Practice Address - Phone:713-541-3420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care