Organization
BY YOUR SIDE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA FLANAGAN REGISTERED NURSE (OWNER)
(563) 590-2688
Entity
Organization
Contact information
Practice address
6790 OLDE DAVENPORT RD, LAMOTTE, IA 52054
(563) 590-2688
Mailing address
6790 OLDE DAVENPORT RD, LA MOTTE, IA 52054-9525
(563) 590-2688
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
090942
IA
253Z00000X
In Home Supportive Care Agency
Primary
090942
IA
385H00000X
Respite Care
090942
IA
Other
Enumeration date
02/13/2017
Last updated
02/14/2017
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