Provider Demographics
NPI:1427394550
Name:PROFESSIONAL HOME HEALTH CARE AGENCY, INC.
Entity Type:Organization
Organization Name:PROFESSIONAL HOME HEALTH CARE AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBANION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-877-1135
Mailing Address - Street 1:141 PROSPEROUS PL
Mailing Address - Street 2:SUITE 24A
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1848
Mailing Address - Country:US
Mailing Address - Phone:606-877-1135
Mailing Address - Fax:
Practice Address - Street 1:141 PROSPEROUS PL
Practice Address - Street 2:SUITE 24A
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1848
Practice Address - Country:US
Practice Address - Phone:606-877-1135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROFESSIONAL HOME HEALTH CARE AGENCY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health