Provider Demographics
NPI:1437478401
Name:LILLIE HOME CARE LLC
Entity Type:Organization
Organization Name:LILLIE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:YVETTTE
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:404-606-4035
Mailing Address - Street 1:4766 SUTTON ST
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-3250
Mailing Address - Country:US
Mailing Address - Phone:720-949-6089
Mailing Address - Fax:303-496-1110
Practice Address - Street 1:4766 SUTTON ST
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-3250
Practice Address - Country:US
Practice Address - Phone:720-949-6089
Practice Address - Fax:303-496-1110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care