Provider Demographics
NPI:1710153226
Name:HOME HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:HOME HEALTH CARE SERVICES LLC
Other - Org Name:TIMBER RIDGE WELLNESS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VP
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-272-5866
Mailing Address - Street 1:100 TIMBER RIDGE RD NW
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-8641
Mailing Address - Country:US
Mailing Address - Phone:425-427-5200
Mailing Address - Fax:425-427-5207
Practice Address - Street 1:800 NW 17TH AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-2581
Practice Address - Country:US
Practice Address - Phone:561-272-5866
Practice Address - Fax:561-243-3733
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LCS HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA=========OtherTAX ID NUMBER