Provider Demographics
NPI:1508119173
Name:LEWIS & LEIGH INC
Entity Type:Organization
Organization Name:LEWIS & LEIGH INC
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:STCLAIR
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:703-530-1360
Mailing Address - Street 1:9817 GODWIN DR
Mailing Address - Street 2:STE 202
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4156
Mailing Address - Country:US
Mailing Address - Phone:703-530-1360
Mailing Address - Fax:
Practice Address - Street 1:9817 GODWIN DR
Practice Address - Street 2:STE 202
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4156
Practice Address - Country:US
Practice Address - Phone:703-530-1360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO13539253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAHCO13539OtherVA HOME CARE