Provider Demographics
NPI:1770963605
Name:LASIK HOME HEALTHCARE INC
Entity type:Organization
Organization Name:LASIK HOME HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-418-0739
Mailing Address - Street 1:9723 PRAIRE AVENUE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-2606
Mailing Address - Country:US
Mailing Address - Phone:219-513-8201
Mailing Address - Fax:219-513-9512
Practice Address - Street 1:9723 PRAIRE AVENUE
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-2606
Practice Address - Country:US
Practice Address - Phone:219-513-8201
Practice Address - Fax:219-513-9512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-05
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN15-013717-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health