Provider Demographics
NPI:1366044257
Name:HOMENSTEAD HEALTHCARE LLC
Entity Type:Organization
Organization Name:HOMENSTEAD HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:LYNNDY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:BYRGE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:931-261-7421
Mailing Address - Street 1:1004 RUSSELL RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555
Mailing Address - Country:US
Mailing Address - Phone:931-261-7421
Mailing Address - Fax:
Practice Address - Street 1:1004 RUSSELL RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555
Practice Address - Country:US
Practice Address - Phone:931-261-7421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-15
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care