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General NPI Number Information
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NPI Number | 1295211514
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Entity Type | Organization
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Legal Business Name | L&S HOME HEALTH CARE
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 5609 HIGHWAY 79
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City | VERNON
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State | FL
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Zip | 32462-3872
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Country | US
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Telephone | 850-703-1191
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 194
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City | EBRO
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State | FL
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Zip | 32437-0194
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Country | US
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Telephone | 850-703-1191
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELEXA-RAY ELNORA LOYD
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Credential | CNA, HHA, DIRECTOR
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Telephone | 850-703-1191
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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 | L18000150384
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License Number State | FL
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