Provider Demographics
NPI:1598532541
Name:LUCENT HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:LUCENT HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:KYEREMATENG
Authorized Official - Last Name:AMPOMAH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:703-445-5360
Mailing Address - Street 1:2010 OPITZ BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3359
Mailing Address - Country:US
Mailing Address - Phone:703-445-5360
Mailing Address - Fax:703-782-6677
Practice Address - Street 1:2010 OPITZ BLVD STE B
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3359
Practice Address - Country:US
Practice Address - Phone:703-445-5360
Practice Address - Fax:703-782-6677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Single Specialty