Provider Demographics
NPI:1629461686
Name:LEH OPERATING, LLC
Entity Type:Organization
Organization Name:LEH OPERATING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTNICKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-933-9280
Mailing Address - Street 1:4711 GOLF ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SKOIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1236
Mailing Address - Country:US
Mailing Address - Phone:847-933-9280
Mailing Address - Fax:
Practice Address - Street 1:151 9TH AVE
Practice Address - Street 2:
Practice Address - City:LITTLE EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08087-4218
Practice Address - Country:US
Practice Address - Phone:609-294-3200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-13
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
315456Medicare Oscar/Certification