Provider Demographics
NPI:1386617884
Name:DEMING HOME CARE SERVICES, LLC
Entity type:Organization
Organization Name:DEMING HOME CARE SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:LYLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-891-1044
Mailing Address - Street 1:9510 ORMSBY STATION RD
Mailing Address - Street 2:STE 300
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4081
Mailing Address - Country:US
Mailing Address - Phone:502-891-1187
Mailing Address - Fax:502-891-8067
Practice Address - Street 1:3948 E LOHMAN AVE
Practice Address - Street 2:STE 3
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8274
Practice Address - Country:US
Practice Address - Phone:575-652-3867
Practice Address - Fax:575-652-4983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-07
Last Update Date:2017-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6551251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMN2882Medicaid
NM327110Medicare Oscar/Certification