Provider Demographics
NPI:1568086858
Name:LOR-RAINE HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:LOR-RAINE HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIJUANA
Authorized Official - Middle Name:DEL ROYA
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-528-7921
Mailing Address - Street 1:2413 ROBESON ST STE 1
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-5500
Mailing Address - Country:US
Mailing Address - Phone:910-491-3069
Mailing Address - Fax:
Practice Address - Street 1:2413 ROBESON ST STE 1
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5500
Practice Address - Country:US
Practice Address - Phone:910-491-3069
Practice Address - Fax:910-229-2141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-02
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care