Provider Demographics
NPI:1417464447
Name:LAGOM CARE LLC
Entity Type:Organization
Organization Name:LAGOM CARE LLC
Other - Org Name:LAGOM CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VASTI
Authorized Official - Middle Name:J
Authorized Official - Last Name:MIRANDA CARTAGENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-516-6826
Mailing Address - Street 1:7131 SAUL ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-1216
Mailing Address - Country:US
Mailing Address - Phone:215-987-9917
Mailing Address - Fax:
Practice Address - Street 1:7718 CASTOR AVE STE 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-3624
Practice Address - Country:US
Practice Address - Phone:215-516-6826
Practice Address - Fax:215-302-2050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-29
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care