Provider Demographics
NPI:1679049951
Name:LSE HEALTHCARE
Entity type:Organization
Organization Name:LSE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LATONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:EARLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-290-0995
Mailing Address - Street 1:8115 ORWIN MANOR LN APT 204
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-9008
Mailing Address - Country:US
Mailing Address - Phone:904-290-0995
Mailing Address - Fax:
Practice Address - Street 1:8115 ORWIN MANOR LN APT 204
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-9008
Practice Address - Country:US
Practice Address - Phone:904-290-0995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health