Provider Demographics
NPI:1740661446
Name:LINCOLN HEALTHCARE, LLC
Entity type:Organization
Organization Name:LINCOLN HEALTHCARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-618-5760
Mailing Address - Street 1:2999 N 44TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-7247
Mailing Address - Country:US
Mailing Address - Phone:480-618-5760
Mailing Address - Fax:
Practice Address - Street 1:100 FRONT ST STE 1275
Practice Address - Street 2:
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-2882
Practice Address - Country:US
Practice Address - Phone:484-406-5000
Practice Address - Fax:484-588-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA03920501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1030095300001Medicaid
PA1030095300001Medicaid