Provider Demographics
NPI:1225047418
Name:LIFECARE HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:LIFECARE HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/CFO
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:R
Authorized Official - Last Name:OLLET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-592-4400
Mailing Address - Street 1:540 E FOOTHILL BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-1250
Mailing Address - Country:US
Mailing Address - Phone:909-592-4400
Mailing Address - Fax:909-592-4425
Practice Address - Street 1:540 E FOOTHILL BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-1250
Practice Address - Country:US
Practice Address - Phone:909-592-4400
Practice Address - Fax:909-592-4425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health