Provider Demographics
NPI:1417763699
Name:LIZ&LAMAR GROUP HOME
Entity type:Organization
Organization Name:LIZ&LAMAR GROUP HOME
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CEASOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-694-7707
Mailing Address - Street 1:518 MAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:PRICHARD
Mailing Address - State:AL
Mailing Address - Zip Code:36610-4048
Mailing Address - Country:US
Mailing Address - Phone:850-694-7707
Mailing Address - Fax:
Practice Address - Street 1:518 MAIN BLVD
Practice Address - Street 2:
Practice Address - City:PRICHARD
Practice Address - State:AL
Practice Address - Zip Code:36610-4048
Practice Address - Country:US
Practice Address - Phone:850-694-7707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-03
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home