Provider Demographics
NPI:1326424367
Name:LK HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:LK HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LADD-GRIMES
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:330-323-2299
Mailing Address - Street 1:PO BOX 5254
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-0254
Mailing Address - Country:US
Mailing Address - Phone:330-520-2221
Mailing Address - Fax:330-776-5557
Practice Address - Street 1:4640 15TH ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-2749
Practice Address - Country:US
Practice Address - Phone:330-323-2299
Practice Address - Fax:330-776-5557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-31
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty