Provider Demographics
NPI:1851571434
Name:LILY A UNIQUE HOME HEALTHCARE CO.
Entity Type:Organization
Organization Name:LILY A UNIQUE HOME HEALTHCARE CO.
Other - Org Name:LILY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-523-8287
Mailing Address - Street 1:PO BOX 3113
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-3113
Mailing Address - Country:US
Mailing Address - Phone:386-523-8287
Mailing Address - Fax:
Practice Address - Street 1:6911 CREFT CIR
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-9461
Practice Address - Country:US
Practice Address - Phone:386-523-8287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health