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General NPI Number Information
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NPI Number | 1104423862
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Entity Type | Organization
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Legal Business Name | LEE SENIOR SERVICES, LLC
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Dates
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Enumeration Date | 10/06/2020
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 16451 HEALTHPARK COMMONS DR
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City | FORT MYERS
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State | FL
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Zip | 33908-9501
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Country | US
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Telephone | 239-349-3300
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Fax | 239-418-2540
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Provider Business Mailing Address
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Address Line | 16451 HEALTHPARK COMMONS DR STE 102
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City | FORT MYERS
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State | FL
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Zip | 33908-9501
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Country | US
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Telephone | 239-297-7377
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Fax | 239-418-2540
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | TROY CHURCHILL
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Credential | ADMINISTRATOR
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Telephone | 239-349-3296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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