Provider Demographics
NPI:1689714503
Name:LRW HOME CARE
Entity Type:Organization
Organization Name:LRW HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASS'T ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DELPHENIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-784-4470
Mailing Address - Street 1:2029 CEDAR POST CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-7362
Mailing Address - Country:US
Mailing Address - Phone:336-784-4470
Mailing Address - Fax:
Practice Address - Street 1:2029 CEDAR POST CT
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27127-7362
Practice Address - Country:US
Practice Address - Phone:336-784-4470
Practice Address - Fax:336-720-9350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1427251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health