Provider Demographics
NPI:1710526678
Name:LASERE HOMECARE
Entity Type:Organization
Organization Name:LASERE HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LALITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MSW
Authorized Official - Phone:330-958-4365
Mailing Address - Street 1:620 E SMITH RD STE W4
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-3648
Mailing Address - Country:US
Mailing Address - Phone:330-721-7590
Mailing Address - Fax:330-721-7591
Practice Address - Street 1:620 E SMITH RD STE W4
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-3648
Practice Address - Country:US
Practice Address - Phone:330-721-7590
Practice Address - Fax:330-721-7591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-24
Last Update Date:2019-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care