Provider Demographics
NPI:1811436645
Name:BY YOUR SIDE CARE LLC
Entity type:Organization
Organization Name:BY YOUR SIDE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLANAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:563-590-2688
Mailing Address - Street 1:6790 OLDE DAVENPORT RD
Mailing Address - Street 2:
Mailing Address - City:LA MOTTE
Mailing Address - State:IA
Mailing Address - Zip Code:52054-9525
Mailing Address - Country:US
Mailing Address - Phone:563-590-2688
Mailing Address - Fax:
Practice Address - Street 1:6790 OLDE DAVENPORT RD
Practice Address - Street 2:
Practice Address - City:LAMOTTE
Practice Address - State:IA
Practice Address - Zip Code:52054
Practice Address - Country:US
Practice Address - Phone:563-590-2688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA090942251E00000X, 385H00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care