Provider Demographics
NPI:1689989758
Name:LECHRIS HEALTH SYSTEMS OF GREENVILLE, INC.
Entity Type:Organization
Organization Name:LECHRIS HEALTH SYSTEMS OF GREENVILLE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:H
Authorized Official - Last Name:SCHWARZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:252-636-6105
Mailing Address - Street 1:2050 EASTGATE DR
Mailing Address - Street 2:STE.E
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-4283
Mailing Address - Country:US
Mailing Address - Phone:252-353-8452
Mailing Address - Fax:252-353-8457
Practice Address - Street 1:2050 EASTGATE DR
Practice Address - Street 2:STE.E
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-4283
Practice Address - Country:US
Practice Address - Phone:252-353-8452
Practice Address - Fax:252-353-8457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300230GMedicaid