Healthcare Provider Details

I. General information

NPI: 1366110215
Provider Name (Legal Business Name): L AND L HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2021
Last Update Date: 04/05/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5306 SEDGWICK DR
JACKSON MS
39211-4325
US

IV. Provider business mailing address

PO BOX 12632
JACKSON MS
39236-2632
US

V. Phone/Fax

Practice location:
  • Phone: 601-502-5185
  • Fax:
Mailing address:
  • Phone: 866-218-5195
  • Fax: 601-898-6188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: VALENCIA ROBINSON
Title or Position: OWNER
Credential:
Phone: 601-502-5185