# LIFE CARE HOME SERVICES OF NORTHWESTERN PENNSYLVANIA LLP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Great Lakes Home Healthcare Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649445255
- **Authorized official:** MRS. KATHY L DUBOWSKI RN, MSN (PRESIDENT)
- **Authorized official phone:** (814) 877-6121

## Contact information

- **Practice address:** 1700 PEACH ST, STE 104, ERIE, PA 16501-2134
- **Practice address phone:** (814) 877-6121
- **Practice address fax:** (814) 877-3027
- **Mailing address:** 1647 SASSAFRAS ST, ERIE, PA 16502-1858
- **Mailing address phone:** (814) 877-6121
- **Mailing address fax:** (814) 459-1858

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | — | NULL | — |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | NULL | Yes |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | — |

## Other

- **Enumeration date:** 04/24/2008
- **Last updated:** 03/17/2011