Provider Demographics
NPI:1912213463
Name:L.A. HOME HEALTHCARE, INC
Entity Type:Organization
Organization Name:L.A. HOME HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LIBAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-840-9300
Mailing Address - Street 1:6161 BUSCH BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-2508
Mailing Address - Country:US
Mailing Address - Phone:614-840-9300
Mailing Address - Fax:614-840-9301
Practice Address - Street 1:6161 BUSCH BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-2508
Practice Address - Country:US
Practice Address - Phone:614-840-9300
Practice Address - Fax:614-840-9301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-22
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH201022800817251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH368403Medicare UPIN