Provider Demographics
NPI:1972242428
Name:LYBL LLC
Entity Type:Organization
Organization Name:LYBL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:NICHOLE
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:660-530-7081
Mailing Address - Street 1:166 W ARROW SUITE 2
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MO
Mailing Address - Zip Code:65340
Mailing Address - Country:US
Mailing Address - Phone:660-530-7081
Mailing Address - Fax:660-476-4426
Practice Address - Street 1:1325 S HIGHLAND CT
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MO
Practice Address - Zip Code:65340-3058
Practice Address - Country:US
Practice Address - Phone:660-530-7081
Practice Address - Fax:660-476-4426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing PersonnelGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care FacilityGroup - Single Specialty
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home