Organization
LAKESHORE COMMUNITY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD A. RUEDY (CEO)
(814) 456-9962
Entity
Organization
Contact information
Practice address
1350 W 26TH ST, ERIE, PA 16508-1402
(814) 456-9962
(814) 456-0595
Mailing address
1350 W 26TH ST, ERIE, PA 16508-1402
(814) 456-9962
(814) 456-0595
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000010470079
—
PA
Enumeration date
01/08/2007
Last updated
08/22/2020
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