Provider Demographics
NPI:1326759895
Name:LIFE CENTER HOME CARE LLC
Entity Type:Organization
Organization Name:LIFE CENTER HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUMIKCHHYA
Authorized Official - Middle Name:
Authorized Official - Last Name:GURUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-892-4005
Mailing Address - Street 1:6580 MIFFLIN AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-4537
Mailing Address - Country:US
Mailing Address - Phone:717-982-4005
Mailing Address - Fax:
Practice Address - Street 1:6580 MIFFLIN AVE
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-4537
Practice Address - Country:US
Practice Address - Phone:717-982-4005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care