Provider Demographics
NPI:1205128501
Name:LUTHERAN HOME CARE PERSONAL ASSISTANCE
Entity type:Organization
Organization Name:LUTHERAN HOME CARE PERSONAL ASSISTANCE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP CFO
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KALBFLEISCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-262-7388
Mailing Address - Street 1:100 MAYER RD
Mailing Address - Street 2:
Mailing Address - City:FRANKENMUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48734-1334
Mailing Address - Country:US
Mailing Address - Phone:989-262-7405
Mailing Address - Fax:
Practice Address - Street 1:5935 SHATTUCK RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-2699
Practice Address - Country:US
Practice Address - Phone:989-262-7444
Practice Address - Fax:989-262-7445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-05
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health