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Organization

LILLY PAD HOME HEALTH, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LATONYA HAILES (ADMINSTRATOR)
(601) 336-6114
Entity
Organization

Contact information

Practice address
1507 HARDY ST STE 201, HATTIESBURG, MS 39401-4978
(601) 336-6114
(888) 449-9560
Mailing address
1507 HARDY ST STE 201, HATTIESBURG, MS 39401-4978
(601) 336-6114
(888) 449-9560

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
163WC0400X
Case Management Registered Nurse
163WC1600X
Continuing Education/Staff Development Registered Nurse
163WC2100X
Continence Care Registered Nurse
163WD0400X
Diabetes Educator Registered Nurse
163WD1100X
Peritoneal Dialysis Registered Nurse
163WF0300X
Flight Registered Nurse
163WG0600X
Gerontology Registered Nurse
163WH0200X
Home Health Registered Nurse
163WH1000X
Hospice Registered Nurse
163WI0500X
Infusion Therapy Registered Nurse
163WI0600X
Infection Control Registered Nurse
163WP0200X
Pediatric Registered Nurse
163WS0200X
School Registered Nurse
163WW0000X
Wound Care Registered Nurse

Other

Enumeration date
04/20/2018
Last updated
12/12/2018
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