Organization
PROFESSIONAL HOME HEALTH CARE AGENCY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOYCE LEWIS (CEO)
(606) 877-1135
Entity
Organization
Contact information
Practice address
4934 S LAUREL RD, LONDON, KY 40744-7985
(606) 864-0724
(606) 864-5256
Mailing address
4934 S LAUREL RD, LONDON, KY 40744-7985
(606) 864-0724
(606) 864-5256
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
42620021
KY
251E00000X
Home Health Agency
Primary
150090
KY
251J00000X
Nursing Care Agency
—
KY
251X00000X
Supports Brokerage Agency
90012964
KY
252Y00000X
Early Intervention Provider Agency
45343969
KY
291U00000X
Clinical Medical Laboratory
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34620039
—
KY
01
—
42620021
HCBW
KY
01
—
45343969
EPSDT
KY
01
—
90012964
KMA DME
KY
Enumeration date
10/11/2005
Last updated
01/28/2015
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