Provider Demographics
NPI:1508350273
Name:LYNEIWA HOME CARE SERVICES
Entity Type:Organization
Organization Name:LYNEIWA HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA
Authorized Official - Prefix:
Authorized Official - First Name:WILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCINNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-694-0534
Mailing Address - Street 1:409 JACK COLEMAN DR NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35805-2637
Mailing Address - Country:US
Mailing Address - Phone:256-694-0534
Mailing Address - Fax:
Practice Address - Street 1:409 JACK COLEMAN DR NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-2637
Practice Address - Country:US
Practice Address - Phone:256-694-0534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health