Provider Demographics
NPI:1063293330
Name:LILY & ROSE HOME CARE
Entity type:Organization
Organization Name:LILY & ROSE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:ASIOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-853-4543
Mailing Address - Street 1:504 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:RIDLEY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19078-3208
Mailing Address - Country:US
Mailing Address - Phone:703-853-4543
Mailing Address - Fax:
Practice Address - Street 1:504 HARRISON ST
Practice Address - Street 2:
Practice Address - City:RIDLEY PARK
Practice Address - State:PA
Practice Address - Zip Code:19078-3208
Practice Address - Country:US
Practice Address - Phone:703-853-4543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health