Provider Demographics
NPI:1467167940
Name:L & L HOMECARE AGENCY LLC
Entity Type:Organization
Organization Name:L & L HOMECARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAKOSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUARLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-320-8335
Mailing Address - Street 1:155 CEDAR ST LOT A
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:39601-3190
Mailing Address - Country:US
Mailing Address - Phone:601-320-8335
Mailing Address - Fax:
Practice Address - Street 1:155 CEDAR ST LOT A
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:MS
Practice Address - Zip Code:39601-3190
Practice Address - Country:US
Practice Address - Phone:601-320-8335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-18
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care