Organization
LIONESS COMMUNITY CARE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY EDWARDS COLEMAN (OWNER/PRESIDENT)
(412) 712-6525
Entity
Organization
Contact information
Practice address
1 PPG PL FL 31, PITTSBURGH, PA 15222-5415
(412) 712-6525
Mailing address
6425 LIVING PLACE, SUITE 200, PITTSBURGH, PA 15206
(412) 712-6525
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102766423
—
PA
01
—
102766423-0014
MEDICARE
PA
Enumeration date
01/31/2013
Last updated
06/07/2019
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