Provider Demographics
NPI:1841024130
Name:LUKAS BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:LUKAS BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:LUKAS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:301-876-4889
Mailing Address - Street 1:618 N MECHANIC ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-2113
Mailing Address - Country:US
Mailing Address - Phone:301-876-4889
Mailing Address - Fax:
Practice Address - Street 1:1305 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-3107
Practice Address - Country:US
Practice Address - Phone:301-876-4889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUKAS BEHAVIORAL HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)