Provider Demographics
NPI:1144504176
Name:LDB HEALTH SYSTEMS LLC
Entity type:Organization
Organization Name:LDB HEALTH SYSTEMS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:LIJANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-299-2319
Mailing Address - Street 1:450 MORTHLAND DR
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-5461
Mailing Address - Country:US
Mailing Address - Phone:219-299-2319
Mailing Address - Fax:
Practice Address - Street 1:450 MORTHLAND DR
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-5461
Practice Address - Country:US
Practice Address - Phone:219-299-2319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11-012679-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health