Provider Demographics
NPI:1295130474
Name:LARIE HOME CARE SERVICES & STAFFING
Entity type:Organization
Organization Name:LARIE HOME CARE SERVICES & STAFFING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR ADVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:KALU
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:888-851-5967
Mailing Address - Street 1:12401 ACADEMY RD
Mailing Address - Street 2:210
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19154-1932
Mailing Address - Country:US
Mailing Address - Phone:888-851-5967
Mailing Address - Fax:267-538-6529
Practice Address - Street 1:12401 ACADEMY RD
Practice Address - Street 2:210
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19154-1932
Practice Address - Country:US
Practice Address - Phone:888-851-5967
Practice Address - Fax:267-538-6529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA26203601251G00000X, 253Z00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care