Provider Demographics
NPI:1689118267
Name:LRD MANAGEMENT INC.
Entity Type:Organization
Organization Name:LRD MANAGEMENT INC.
Other - Org Name:CARING SENIOR SERVICE OF CHARLESTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-550-7480
Mailing Address - Street 1:335 4TH AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25303-1268
Mailing Address - Country:US
Mailing Address - Phone:304-553-7802
Mailing Address - Fax:681-205-2617
Practice Address - Street 1:335 4TH AVE STE 104
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25303-1268
Practice Address - Country:US
Practice Address - Phone:304-553-7802
Practice Address - Fax:681-205-2617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2017-9498-00253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care