Provider Demographics
NPI:1740016211
Name:LASTING IMPRESSION HOME CAE SERVICES LLC
Entity type:Organization
Organization Name:LASTING IMPRESSION HOME CAE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUVENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-253-6440
Mailing Address - Street 1:261 OLD YORK RD STE 520A
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-3721
Mailing Address - Country:US
Mailing Address - Phone:215-253-6440
Mailing Address - Fax:267-540-7068
Practice Address - Street 1:261 OLD YORK RD STE 520A
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3721
Practice Address - Country:US
Practice Address - Phone:215-253-6440
Practice Address - Fax:267-540-7068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-11
Last Update Date:2024-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care