Healthcare Provider Details

I. General information

NPI: 1558962993
Provider Name (Legal Business Name): ANLEE RESIDENTIAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2020
Last Update Date: 11/03/2020
Certification Date: 11/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 STUMP HOLLOW RD SE
LANCASTER OH
43130-9038
US

IV. Provider business mailing address

PO BOX 925
LANCASTER OH
43130-0925
US

V. Phone/Fax

Practice location:
  • Phone: 740-808-0775
  • Fax:
Mailing address:
  • Phone: 740-808-0775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TRACY WRIGHT
Title or Position: ADMINISTRATIVE ASSISTANT
Credential:
Phone: 740-808-0775