Provider Demographics
NPI:1821686486
Name:LT HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:LT HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIRUS
Authorized Official - Middle Name:
Authorized Official - Last Name:GITAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-368-9910
Mailing Address - Street 1:PO BOX 1113
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98071-1113
Mailing Address - Country:US
Mailing Address - Phone:253-368-9910
Mailing Address - Fax:253-409-2480
Practice Address - Street 1:1030 42ND CT NE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-0005
Practice Address - Country:US
Practice Address - Phone:253-368-9910
Practice Address - Fax:253-409-2480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-08
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care