Provider Demographics
NPI:1134885098
Name:LEMON JUICE HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:LEMON JUICE HEALTHCARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:VONITA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISIDORE
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:678-378-3119
Mailing Address - Street 1:2812 N DR WILLIAM FINLAYSON ST APT 506
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-2356
Mailing Address - Country:US
Mailing Address - Phone:678-372-3119
Mailing Address - Fax:
Practice Address - Street 1:2817 JAMES HENRY DR
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-7553
Practice Address - Country:US
Practice Address - Phone:678-638-9579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEMON JUICE HEALTHCARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-15
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local