Provider Demographics
NPI:1528389665
Name:LAVENDER HOME CARE SOLUTIONS
Entity Type:Organization
Organization Name:LAVENDER HOME CARE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DALICHAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-660-6901
Mailing Address - Street 1:721 SPRINGFIELD ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45403-1250
Mailing Address - Country:US
Mailing Address - Phone:937-660-6901
Mailing Address - Fax:
Practice Address - Street 1:721 SPRINGFIELD ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45403-1250
Practice Address - Country:US
Practice Address - Phone:937-660-6901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-11
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care