Provider Demographics
NPI:1649462334
Name:LUCENT HOME HEALTH LLC
Entity type:Organization
Organization Name:LUCENT HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:KOENEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-298-2182
Mailing Address - Street 1:1255 W 15TH ST STE 900
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-4214
Mailing Address - Country:US
Mailing Address - Phone:972-664-0945
Mailing Address - Fax:972-664-0139
Practice Address - Street 1:1255 W 15TH ST STE 900
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-4214
Practice Address - Country:US
Practice Address - Phone:972-664-0945
Practice Address - Fax:972-664-0139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX743191Medicare Oscar/Certification