Provider Demographics
NPI:1386780757
Name:LISENBY HOME CARE, INC.
Entity type:Organization
Organization Name:LISENBY HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:LISENBY
Authorized Official - Last Name:PARMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-769-0440
Mailing Address - Street 1:412 N COVE BLVD
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-3726
Mailing Address - Country:US
Mailing Address - Phone:850-769-0440
Mailing Address - Fax:850-784-0218
Practice Address - Street 1:412 N COVE BLVD
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3726
Practice Address - Country:US
Practice Address - Phone:850-769-0440
Practice Address - Fax:850-784-0218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20651096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health