Provider Demographics
NPI:1497196745
Name:ERICKSON LIVING HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:ERICKSON LIVING HEALTH SERVICES, LLC
Other - Org Name:ERICKSON LIVING HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-402-2323
Mailing Address - Street 1:100 MARIS GROVE WAY
Mailing Address - Street 2:ATTN: EXECUTIVE DIRECTOR
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1282
Mailing Address - Country:US
Mailing Address - Phone:610-387-4470
Mailing Address - Fax:410-204-7237
Practice Address - Street 1:100 MARIS GROVE WAY
Practice Address - Street 2:ATTN: EXECUTIVE DIRECTOR
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1282
Practice Address - Country:US
Practice Address - Phone:610-387-4470
Practice Address - Fax:410-204-7237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health