Provider Demographics
NPI:1154769834
Name:LADY C SERVICES LLC.
Entity type:Organization
Organization Name:LADY C SERVICES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CONNIELYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:4048389513
Authorized Official - Phone:404-838-9513
Mailing Address - Street 1:5152 MEMORIAL DR UNIT 830627
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-0106
Mailing Address - Country:US
Mailing Address - Phone:404-838-9513
Mailing Address - Fax:
Practice Address - Street 1:5152 MEMORIAL DR UNIT 830627
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-0106
Practice Address - Country:US
Practice Address - Phone:404-838-9513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based