Healthcare Provider Details

I. General information

NPI: 1962306498
Provider Name (Legal Business Name): FOUR LILLIES FAMILY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3683 TYLER RD
TWIN LAKE MI
49457-9234
US

IV. Provider business mailing address

3683 TYLER RD
TWIN LAKE MI
49457-9234
US

V. Phone/Fax

Practice location:
  • Phone: 231-286-4232
  • Fax:
Mailing address:
  • Phone: 231-286-4232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ORLONDA THOMPSON
Title or Position: OWNER
Credential:
Phone: 231-286-4232