Organization
BLUELILIES HEALTHCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNDA R FAKUNLE (DIRECTOR OF NURSING)
(817) 689-0231
Entity
Organization
Contact information
Practice address
6746 LENNOX ST, FORT MILL, SC 29707-5518
(817) 689-0231
(704) 684-5228
Mailing address
2111 ABUNDANCE LN, WAXHAW, NC 28173-0352
(817) 689-0231
(704) 684-5228
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
251T00000X
PACE Provider Organization
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
02/04/2022
Last updated
02/04/2022
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