Organization
LILLY HOMECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAVIN STEPHENSON (OWNER)
(602) 332-8199
Entity
Organization
Contact information
Practice address
12218 W MONROE ST, AVONDALE, AZ 85323-8080
(602) 332-8199
Mailing address
12218 W MONROE ST, AVONDALE, AZ 85323-8080
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
04/05/2024
Last updated
04/05/2024
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