Provider Demographics
NPI:1083851596
Name:L. AND J. WEBB INCORPORATED
Entity Type:Organization
Organization Name:L. AND J. WEBB INCORPORATED
Other - Org Name:COMFORT KEEPERS #259
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADM/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:ADM
Authorized Official - Phone:765-827-2001
Mailing Address - Street 1:3048 WESTERN AVE.
Mailing Address - Street 2:
Mailing Address - City:CONNERSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47331-2555
Mailing Address - Country:US
Mailing Address - Phone:765-827-2001
Mailing Address - Fax:765-827-2005
Practice Address - Street 1:3048 WESTERN AVE.
Practice Address - Street 2:
Practice Address - City:CONNERSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47331-2555
Practice Address - Country:US
Practice Address - Phone:765-827-2001
Practice Address - Fax:765-827-2005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08-011983-1253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care