Provider Demographics
NPI:1518584945
Name:LEAN ON ME CAREGIVING
Entity Type:Organization
Organization Name:LEAN ON ME CAREGIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SWOFFORD
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:618-283-9490
Mailing Address - Street 1:507 W GALLATIN ST
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:IL
Mailing Address - Zip Code:62471-2748
Mailing Address - Country:US
Mailing Address - Phone:618-283-9490
Mailing Address - Fax:618-283-9490
Practice Address - Street 1:507 W GALLATIN ST
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:IL
Practice Address - Zip Code:62471-2748
Practice Address - Country:US
Practice Address - Phone:618-283-9490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty