Provider Demographics
NPI:1124732219
Name:LEC ENTERPRISES PENNSYLVANIA LLC
Entity type:Organization
Organization Name:LEC ENTERPRISES PENNSYLVANIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:BROOKS
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-786-9307
Mailing Address - Street 1:270 WALKER DR STE 102W
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-7097
Mailing Address - Country:US
Mailing Address - Phone:814-954-8002
Mailing Address - Fax:814-690-2087
Practice Address - Street 1:270 WALKER DR STE 102W
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7097
Practice Address - Country:US
Practice Address - Phone:814-954-8002
Practice Address - Fax:814-690-2087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care