# LACKAWANNA HEALTH CARE CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lackawanna Health and Rehab Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376865550
- **Authorized official:** ELI STROHLI (PRESIDENT)
- **Authorized official phone:** (305) 864-9191

## Contact information

- **Practice address:** 108 TERRACE DR, OLYPHANT, PA 18447-2503
- **Practice address phone:** (570) 489-8611
- **Mailing address:** 108 TERRACE DR, OLYPHANT, PA 18447-2503
- **Mailing address phone:** (570) 489-8611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 02/16/2010
- **Last updated:** 02/16/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 39-5414 | MEDICARE | PA |