Provider Demographics
NPI:1649786294
Name:THE LUTHERAN SERVICE SOCIETY OF WESTERN PA
Entity type:Organization
Organization Name:THE LUTHERAN SERVICE SOCIETY OF WESTERN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-734-9330
Mailing Address - Street 1:440 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15202-3631
Mailing Address - Country:US
Mailing Address - Phone:412-734-9330
Mailing Address - Fax:412-734-1844
Practice Address - Street 1:440 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15202-3631
Practice Address - Country:US
Practice Address - Phone:412-734-9330
Practice Address - Fax:412-734-1844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals