Provider Demographics
NPI:1598524522
Name:LEE, LASHONA (CEO,CMA,HHA)
Entity Type:Individual
Prefix:
First Name:LASHONA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:CEO,CMA,HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7740 COLE WOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46239-7780
Mailing Address - Country:US
Mailing Address - Phone:317-201-2340
Mailing Address - Fax:
Practice Address - Street 1:7740 COLE WOOD BLVD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46239-7780
Practice Address - Country:US
Practice Address - Phone:317-201-2340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN2301596313747P1801X, 376J00000X, 3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker