Provider Demographics
NPI:1124080643
Name:LEE COUNTY HOME HEALTH LLC
Entity type:Organization
Organization Name:LEE COUNTY HOME HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:T
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:334-745-7966
Mailing Address - Street 1:2214 GATEWAY DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-6832
Mailing Address - Country:US
Mailing Address - Phone:334-745-7966
Mailing Address - Fax:334-745-2153
Practice Address - Street 1:2214 GATEWAY DR
Practice Address - Street 2:SUITE B
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-1500
Practice Address - Country:US
Practice Address - Phone:334-745-7966
Practice Address - Fax:334-745-2153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0600020440251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALSOU7147AMedicaid
AL017147Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER