Provider Demographics
NPI:1538117395
Name:LANCASTER-LEBANON INTERMEDIATE UNIT
Entity Type:Organization
Organization Name:LANCASTER-LEBANON INTERMEDIATE UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAUSNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-519-1096
Mailing Address - Street 1:1110 ENTERPRISE RD
Mailing Address - Street 2:
Mailing Address - City:EAST PETERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17520-1604
Mailing Address - Country:US
Mailing Address - Phone:717-560-4670
Mailing Address - Fax:717-560-6192
Practice Address - Street 1:1110 ENTERPRISE RD
Practice Address - Street 2:
Practice Address - City:EAST PETERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17520-1604
Practice Address - Country:US
Practice Address - Phone:717-560-4670
Practice Address - Fax:717-560-6192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007584870001Medicaid