Provider Demographics
NPI:1003628090
Name:SANDRA LEES IN-HOME CARE LLC
Entity type:Organization
Organization Name:SANDRA LEES IN-HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:MEADOWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-329-1696
Mailing Address - Street 1:9352 GREENLEAF DR
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36527-5570
Mailing Address - Country:US
Mailing Address - Phone:219-329-1696
Mailing Address - Fax:
Practice Address - Street 1:9352 GREENLEAF DR
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36527-5570
Practice Address - Country:US
Practice Address - Phone:219-329-1696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-25
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care