Basic Information
Provider Information
NPI: 1194139832
EntityType: 2
ReplacementNPI:  
OrganizationName: LHCG LX, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: LIFE CARE AT HOME
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 51266
Address2:  
City: LAFAYETTE
State: LA
PostalCode: 705051266
CountryCode: US
TelephoneNumber: 3372331307
FaxNumber: 3372335764
Practice Location
Address1: 2200 W PARKWAY BLVD
Address2: SUITE 200
City: SALT LAKE CITY
State: UT
PostalCode: 841192099
CountryCode: US
TelephoneNumber: 8019725802
FaxNumber: 8019730246
Other Information
ProviderEnumerationDate: 06/19/2014
LastUpdateDate: 07/30/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: STELLY
AuthorizedOfficialFirstName: DONALD
AuthorizedOfficialMiddleName: D
AuthorizedOfficialTitleorPosition: PRESIDENT, LHC GROUP, INC.
AuthorizedOfficialTelephone: 3372331307
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000X  Y AgenciesHome Health 

No ID Information.


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