Provider Demographics
NPI:1891197620
Name:Z LARUE ENTERPRISES, LLC
Entity Type:Organization
Organization Name:Z LARUE ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ZINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SPEIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-747-5473
Mailing Address - Street 1:5825 COBBS CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-3035
Mailing Address - Country:US
Mailing Address - Phone:215-747-5473
Mailing Address - Fax:
Practice Address - Street 1:5825 COBBS CREEK PKWY
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-3035
Practice Address - Country:US
Practice Address - Phone:215-747-5473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-24
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X, 252Y00000X, 253Z00000X, 332U00000X
PA347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No253Z00000XAgenciesIn Home Supportive Care
No332U00000XSuppliersHome Delivered Meals
No347C00000XTransportation ServicesPrivate Vehicle