# LECOM SENIOR LIVING CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MILLCREEK MANOR
- **Other names:** Millcreek Manor
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1891237665
- **Legal business name:** MILLCREEK MANOR
- **Authorized official:** DR. MELANIE RAE TITZEL PH.D. (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** 81486833812

## Contact information

- **Practice address:** 5535 PEACH STREET, ERIE, PA 16509-8528
- **Practice address phone:** (814) 868-3820
- **Practice address fax:** (814) 868-3887
- **Mailing address:** 5535 PEACH STREET, ERIE, PA 16509-8528
- **Mailing address phone:** (814) 868-3820
- **Mailing address fax:** (814) 868-3887

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133NN1002X | Nutrition Education Nutritionist | 806473 | NULL | Yes |
| 133NN1002X | Nutrition Education Nutritionist | 806473 | — | Yes |

## Other

- **Enumeration date:** 11/10/2016
- **Last updated:** 11/10/2016