Provider Demographics
NPI:1124321500
Name:LEL HOME SERVICES, LLC
Entity type:Organization
Organization Name:LEL HOME SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:DUNCAN
Authorized Official - Last Name:EICHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-387-1443
Mailing Address - Street 1:5555 W 73RD ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-2162
Mailing Address - Country:US
Mailing Address - Phone:317-387-1443
Mailing Address - Fax:317-356-6661
Practice Address - Street 1:5555 W 73RD ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-2162
Practice Address - Country:US
Practice Address - Phone:317-387-1443
Practice Address - Fax:317-356-6661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN253Z00000X253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200109560AMedicaid
IN=========OtherEIN