Provider Demographics
NPI:1710409982
Name:LEAVY HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:LEAVY HEALTHCARE SERVICES, INC.
Other - Org Name:LHS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEAVY
Authorized Official - Suffix:
Authorized Official - Credentials:LEAVY HEALTHCARE SER
Authorized Official - Phone:856-677-6115
Mailing Address - Street 1:906 MASON RUN
Mailing Address - Street 2:
Mailing Address - City:PINE HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08021
Mailing Address - Country:US
Mailing Address - Phone:856-677-6115
Mailing Address - Fax:856-258-4550
Practice Address - Street 1:906 MASON RUN
Practice Address - Street 2:
Practice Address - City:PINE HILL
Practice Address - State:NJ
Practice Address - Zip Code:08021
Practice Address - Country:US
Practice Address - Phone:856-677-6115
Practice Address - Fax:856-258-4550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-10
Last Update Date:2017-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0257200251E00000X
NJ505-427-825-08021343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)