Provider Demographics
NPI:1437914504
Name:LAVENDER HILLS HOME CARE, LLC
Entity Type:Organization
Organization Name:LAVENDER HILLS HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:HAO
Authorized Official - Middle Name:
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:509-591-7136
Mailing Address - Street 1:816 LASSEN VOLCANIC DR
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-0018
Mailing Address - Country:US
Mailing Address - Phone:509-591-7136
Mailing Address - Fax:
Practice Address - Street 1:816 LASSEN VOLCANIC DR
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-0018
Practice Address - Country:US
Practice Address - Phone:509-591-7136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care