Provider Demographics
NPI:1790468387
Name:A HOME FOR LYRIC LLC
Entity Type:Organization
Organization Name:A HOME FOR LYRIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:LASONE
Authorized Official - Middle Name:K
Authorized Official - Last Name:HOSKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:757-748-2661
Mailing Address - Street 1:809 ABERDEEN RD UNIT 9578
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23670-1220
Mailing Address - Country:US
Mailing Address - Phone:757-748-2661
Mailing Address - Fax:
Practice Address - Street 1:116 PRINCE GEORGE DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-3604
Practice Address - Country:US
Practice Address - Phone:757-236-9896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities