Provider Demographics
NPI:1043565484
Name:L & L RESPITE, LLC.
Entity type:Organization
Organization Name:L & L RESPITE, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUTHIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-876-6169
Mailing Address - Street 1:423 BEULAH AVE
Mailing Address - Street 2:
Mailing Address - City:TYLERTOWN
Mailing Address - State:MS
Mailing Address - Zip Code:39667-2703
Mailing Address - Country:US
Mailing Address - Phone:601-876-6169
Mailing Address - Fax:601-876-6120
Practice Address - Street 1:423 BEULAH AVE
Practice Address - Street 2:
Practice Address - City:TYLERTOWN
Practice Address - State:MS
Practice Address - Zip Code:39667-2703
Practice Address - Country:US
Practice Address - Phone:601-876-6169
Practice Address - Fax:601-876-6120
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:L & L HOMEMAKER, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care