Provider Demographics
NPI:1881000511
Name:LAURENCY OPTIMAL PERSONAL CARE AGENCY
Entity Type:Organization
Organization Name:LAURENCY OPTIMAL PERSONAL CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:HELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAURENCY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-235-6504
Mailing Address - Street 1:136 S FRANKLIN ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18701-1104
Mailing Address - Country:US
Mailing Address - Phone:570-235-6504
Mailing Address - Fax:570-235-6898
Practice Address - Street 1:136 S FRANKLIN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18701-1104
Practice Address - Country:US
Practice Address - Phone:570-235-6504
Practice Address - Fax:570-235-6898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA25383601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health