Provider Demographics
NPI:1578121059
Name:LUMICARE HEALTH CO 1 LLC
Entity Type:Organization
Organization Name:LUMICARE HEALTH CO 1 LLC
Other - Org Name:CHOICE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER, CHIEF GROWTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:LANIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-932-1852
Mailing Address - Street 1:6760 OLD JACKSONVILLE HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-0566
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6041 S SYRACUSE WAY STE 100
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-4716
Practice Address - Country:US
Practice Address - Phone:720-750-8497
Practice Address - Fax:720-750-8498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-30
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based