Provider Demographics
NPI:1215421854
Name:LYON HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:LYON HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS LYON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-966-7238
Mailing Address - Street 1:4308 RIDGEWOOD CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-5307
Mailing Address - Country:US
Mailing Address - Phone:703-763-3252
Mailing Address - Fax:703-763-3911
Practice Address - Street 1:4308 RIDGEWOOD CENTER DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-5307
Practice Address - Country:US
Practice Address - Phone:703-763-3252
Practice Address - Fax:703-763-3911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty