# LUCILLES TENDER HOME CARE AGENCY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033776711
- **Authorized official:** MRS. PATRICIA LEWIS (OWNER)
- **Authorized official phone:** (843) 496-5233

## Contact information

- **Practice address:** 215 BYRNES CIR, JOHNSONVILLE, SC 29555-6516
- **Practice address phone:** (843) 373-0756
- **Mailing address:** 215 BYRNES CIR, JOHNSONVILLE, SC 29555-6516
- **Mailing address phone:** (843) 373-0756

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 05/28/2019
- **Last updated:** 09/16/2019