Provider Demographics
NPI:1477855096
Name:LANDMARK HOMEHEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:LANDMARK HOMEHEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEW
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:310-279-6005
Mailing Address - Street 1:PO BOX 491814
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-8814
Mailing Address - Country:US
Mailing Address - Phone:310-279-6005
Mailing Address - Fax:
Practice Address - Street 1:833 MORAGA DR APT 7
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-1635
Practice Address - Country:US
Practice Address - Phone:310-279-6005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based