Provider Demographics
NPI:1386055127
Name:LUMEN CHRISTI HEALTH CARE INC
Entity type:Organization
Organization Name:LUMEN CHRISTI HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MIRBLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FORETIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-822-2004
Mailing Address - Street 1:1359 HANCOCK ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-5108
Mailing Address - Country:US
Mailing Address - Phone:617-479-0206
Mailing Address - Fax:
Practice Address - Street 1:1359 HANCOCK ST
Practice Address - Street 2:SUITE 6
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5108
Practice Address - Country:US
Practice Address - Phone:617-479-0206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health