Organization
LIFE CARE HOME SERVICES OF NORTHWESTERN PENNSYLVANIA LLP
Active
Other names
Great Lakes Home Healthcare Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY L DUBOWSKI RN, MSN (PRESIDENT)
(814) 877-6121
Entity
Organization
Contact information
Practice address
1647 SASSAFRAS ST, ERIE, PA 16502-1858
(814) 877-6121
(814) 877-6297
Mailing address
1647 SASSAFRAS ST, ERIE, PA 16502-1858
(814) 877-6121
(814) 459-1858
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
006305
PA
164W00000X
Licensed Practical Nurse
006305
PA
251E00000X
Home Health Agency
006305
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007788280007
—
PA
01
—
1379
HIGHMARK BC BS
—
Enumeration date
04/10/2008
Last updated
03/17/2011
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