Provider Demographics
NPI:1548616949
Name:LAHTZE ENTERPRISES LLC
Entity Type:Organization
Organization Name:LAHTZE ENTERPRISES LLC
Other - Org Name:NNY BEHAVIORAL HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:E
Authorized Official - Last Name:DILES
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP BC
Authorized Official - Phone:315-376-0376
Mailing Address - Street 1:7515 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:LOWVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13367-1569
Mailing Address - Country:US
Mailing Address - Phone:315-376-0376
Mailing Address - Fax:315-376-0378
Practice Address - Street 1:7515 S STATE ST
Practice Address - Street 2:
Practice Address - City:LOWVILLE
Practice Address - State:NY
Practice Address - Zip Code:13367-1569
Practice Address - Country:US
Practice Address - Phone:315-376-0376
Practice Address - Fax:315-376-0378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY401513261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health