Provider Demographics
NPI:1821045758
Name:LEE COUNTY HOME HEALTH, LLC
Entity Type:Organization
Organization Name:LEE COUNTY HOME HEALTH, LLC
Other - Org Name:SOUTHERN HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OF MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:FOXWORTHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-767-8882
Mailing Address - Street 1:2214-B GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-6832
Mailing Address - Country:US
Mailing Address - Phone:334-745-7966
Mailing Address - Fax:334-745-2153
Practice Address - Street 1:2214-B GATEWAY DR
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-6832
Practice Address - Country:US
Practice Address - Phone:334-745-7966
Practice Address - Fax:334-745-2153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALSOU7147AMedicaid
ALSOU7147AMedicaid