Provider Demographics
NPI:1598031619
Name:SIMPLE TREASURES IN HOME CARE, INC
Entity Type:Organization
Organization Name:SIMPLE TREASURES IN HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAKIESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LA JE'HANNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-269-0833
Mailing Address - Street 1:93603 W HOWARD LN
Mailing Address - Street 2:
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-4051
Mailing Address - Country:US
Mailing Address - Phone:541-269-0833
Mailing Address - Fax:541-269-0833
Practice Address - Street 1:518 S WALL ST
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-2731
Practice Address - Country:US
Practice Address - Phone:541-269-0833
Practice Address - Fax:541-269-0833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15-2202251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care