Healthcare Provider Details

I. General information

NPI: 1902688005
Provider Name (Legal Business Name): LJS HOMEMAKER AND COMPANION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 10/16/2023
Certification Date: 10/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6220 S ORANGE BLOSSOM TRL STE 143
ORLANDO FL
32809-4677
US

IV. Provider business mailing address

6220 S ORANGE BLOSSOM TRL STE 143
ORLANDO FL
32809-4677
US

V. Phone/Fax

Practice location:
  • Phone: 407-723-3412
  • Fax:
Mailing address:
  • Phone: 407-723-3412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS LETECIA DENISE JAMES SAMUELS
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 407-723-3412