Provider Demographics
NPI:1689194144
Name:LUBESTA HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:LUBESTA HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:O
Authorized Official - Last Name:MOMODU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:856-625-3021
Mailing Address - Street 1:5 MESSINA DR
Mailing Address - Street 2:
Mailing Address - City:WOOLWICH TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-3081
Mailing Address - Country:US
Mailing Address - Phone:856-625-3021
Mailing Address - Fax:
Practice Address - Street 1:5 MESSINA DR
Practice Address - Street 2:
Practice Address - City:WOOLWICH TWP
Practice Address - State:NJ
Practice Address - Zip Code:08085-3081
Practice Address - Country:US
Practice Address - Phone:856-625-3021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health