Provider Demographics
NPI:1902688005
Name:LJS HOMEMAKER AND COMPANION SERVICES LLC
Entity type:Organization
Organization Name:LJS HOMEMAKER AND COMPANION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:LETECIA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:JAMES SAMUELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-723-3412
Mailing Address - Street 1:6220 S ORANGE BLOSSOM TRL STE 143
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-4677
Mailing Address - Country:US
Mailing Address - Phone:407-723-3412
Mailing Address - Fax:
Practice Address - Street 1:6220 S ORANGE BLOSSOM TRL STE 143
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-4677
Practice Address - Country:US
Practice Address - Phone:407-723-3412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL234784OtherAGENCY OF HEALTH CARE ADMINISTRATION