Healthcare Provider Details

I. General information

NPI: 1659833812
Provider Name (Legal Business Name): LEXX HOMECARE AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2019
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3787 LAMB DR
MARIETTA GA
30064-5921
US

IV. Provider business mailing address

3787 LAMB DR
MARIETTA GA
30064-5921
US

V. Phone/Fax

Practice location:
  • Phone: 404-933-7016
  • Fax:
Mailing address:
  • Phone: 404-933-7016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: HELEN KONOMA
Title or Position: RN, OWNER
Credential:
Phone: 404-933-7016