Organization
CLINICAL PRACTICE OF LECOM INSTITUTE FOR SUCCESSFUL LIVING
Active
Organization
CLINICAL PRACTICE OF LECOM INSTITUTE FOR SUCCESSFUL LIVING
Active
Parent organization
MILLCREEK MANOR
Other names
LECOM Clinical Practice Supplies
Organization subpart
Yes
Provider details
NPI number
Legal business name
MILLCREEK MANOR
Authorized official
JAMES LIN (PRESIDENT)
(814) 602-7783
Entity
Organization
Contact information
Practice address
5401 PEACH ST STE 3400, ERIE, PA 16509-2601
(814) 844-2858
Mailing address
5535 PEACH ST, ERIE, PA 16509-2603
(814) 844-2858
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/24/2025
Last updated
07/24/2025
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