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Organization

LHCG CLX LLC

Active
Other names
Mederi Private Care
Organization subpart
No

Provider details

NPI number
Authorized official
JOSHUA L PROFFITT (PRESIDENT)
(337) 233-1307
Entity
Organization

Contact information

Practice address
1117 S WESTMORELAND DR STE C, ORLANDO, FL 32805-3803
(407) 644-2433
(407) 644-0331
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 443-4154

Taxonomy

Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
253Z00000X
In Home Supportive Care Agency
3747A0650X
Attendant Care Provider

Other

Enumeration date
04/23/2020
Last updated
04/28/2023
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