Provider Demographics
NPI:1770382442
Name:A LILLIE OF LOVE HOME CARE AGENCY LLC
Entity type:Organization
Organization Name:A LILLIE OF LOVE HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NYESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUYTON
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:662-255-2970
Mailing Address - Street 1:111 OLD SALTILLO RD
Mailing Address - Street 2:
Mailing Address - City:SALTILLO
Mailing Address - State:MS
Mailing Address - Zip Code:38866-5700
Mailing Address - Country:US
Mailing Address - Phone:662-255-2970
Mailing Address - Fax:
Practice Address - Street 1:111 OLD SALTILLO RD
Practice Address - Street 2:
Practice Address - City:SALTILLO
Practice Address - State:MS
Practice Address - Zip Code:38866-5700
Practice Address - Country:US
Practice Address - Phone:662-255-2970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-13
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies