Organization · NPI-2
Lilly Pad Home Health, LLC
Community/Behavioral Health · Hattiesburg, MS
NPI number1396250031
StatusActive
Last updated in NPPESNov 6, 2019
Details
- NPI
- 1396250031
- Entity type
- Organization (NPI-2)
- Legal business name
- Lilly Pad Home Health, LLC
- Organization subpart
- No
- Enumeration date
- Dec 4, 2017
- Last updated
- Nov 6, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
| 171000000X | Military Health Care Provider | – | – | |
| 251E00000X | Home Health | – | – | |
| 376J00000X | Homemaker | – | – | |
| 385H00000X | Respite Care | – | – |
Other names
- Lilly Pad Home Health, LLC (Former Legal Business Name)
Practice location
1507 Hardy St Ste 201Hattiesburg, MS 39401-4978
Phone 601-410-5836 · Fax 888-449-9560
Mailing address
1507 Hardy St Ste 201Hattiesburg, MS 39401-4978
Phone 601-410-5836 · Fax 888-449-9560
Authorized official
Latonya Hailes
Ceo/Administrator
6013366114
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