Healthcare Provider Details

I. General information

NPI: 1891201158
Provider Name (Legal Business Name): LSJ SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2017
Last Update Date: 12/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 SAINT CLAIR ST STE 205
FRANKFORT KY
40601-1845
US

IV. Provider business mailing address

213 SAINT CLAIR ST STE 205
FRANKFORT KY
40601-1845
US

V. Phone/Fax

Practice location:
  • Phone: 502-699-2550
  • Fax: 502-699-2560
Mailing address:
  • Phone: 502-699-2550
  • Fax: 502-699-2560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateKY

VIII. Authorized Official

Name: MRS. LYDIA MCDONALD JACOBS
Title or Position: DIRECTOR OF CLIENT CARE/EDUCATION
Credential:
Phone: 502-699-2550