=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962306498
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FOUR LILLIES FAMILY CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/07/2026
-----------------------------------------------------
Last Update Date | 10/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3683 TYLER RD
-----------------------------------------------------
City | TWIN LAKE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49457-9234
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 231-286-4232
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3683 TYLER RD
-----------------------------------------------------
City | TWIN LAKE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49457-9234
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 231-286-4232
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ORLONDA THOMPSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 231-286-4232
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------