Provider Demographics
NPI:1952086738
Name:LUCAS FAMILY HOME CARE LLC
Entity type:Organization
Organization Name:LUCAS FAMILY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-781-6366
Mailing Address - Street 1:19190 GREENFIELD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-2001
Mailing Address - Country:US
Mailing Address - Phone:248-781-6366
Mailing Address - Fax:313-646-9764
Practice Address - Street 1:19190 GREENFIELD RD STE 100
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-2001
Practice Address - Country:US
Practice Address - Phone:248-781-6366
Practice Address - Fax:313-646-9764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care