Provider Demographics
NPI:1255463923
Name:LYNN IN-HOME HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:LYNN IN-HOME HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HUTSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:314-837-1660
Mailing Address - Street 1:12912 NEW HALLS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-4035
Mailing Address - Country:US
Mailing Address - Phone:314-837-1660
Mailing Address - Fax:314-837-3447
Practice Address - Street 1:12912 NEW HALLS FERRY RD
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-4035
Practice Address - Country:US
Practice Address - Phone:314-837-1660
Practice Address - Fax:314-837-3447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO8705369251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health