Provider Demographics
NPI:1548067069
Name:LOUS PERSONAL CARE HOME LLC
Entity type:Organization
Organization Name:LOUS PERSONAL CARE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:LIGON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-634-7565
Mailing Address - Street 1:2119 TILLMAN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906-3616
Mailing Address - Country:US
Mailing Address - Phone:706-984-0971
Mailing Address - Fax:
Practice Address - Street 1:2119 TILLMAN ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-3616
Practice Address - Country:US
Practice Address - Phone:706-984-0971
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty