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Organization

LSE PHV LLC

Active
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Organization

LSE PHV LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DARLEY NAZAIRE (DIRECTOR)
(612) 207-3009
Entity
Organization

Contact information

Practice address
46 LINCOLN ST, WINTHROP, MA 02152-2151
(612) 207-3009
Mailing address
46 LINCOLN ST, WINTHROP, MA 02152-2151
(612) 207-3009

Taxonomy

Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
04/17/2026
Last updated
04/17/2026
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