Provider Demographics
NPI:1174271555
Name:LYONS HOME CARE LLC
Entity Type:Organization
Organization Name:LYONS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENITA
Authorized Official - Middle Name:
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-717-9971
Mailing Address - Street 1:443 EAGLE BLVD
Mailing Address - Street 2:
Mailing Address - City:KINGSLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31548-6495
Mailing Address - Country:US
Mailing Address - Phone:912-717-9971
Mailing Address - Fax:912-576-0970
Practice Address - Street 1:443 EAGLE BLVD
Practice Address - Street 2:
Practice Address - City:KINGSLAND
Practice Address - State:GA
Practice Address - Zip Code:31548-6495
Practice Address - Country:US
Practice Address - Phone:912-717-9971
Practice Address - Fax:912-576-0970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty