Organization
CLINICAL PRACTICE OF LECOM INSTITUTE FOR SUCCESSFUL LIVING
Active
Parent organization
MILLCREEK MANOR
Other names
LECOM Restorative Therapy
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
41 W GORE RD, ERIE, PA 16509-3621
(814) 864-4867
Mailing address
41 W GORE RD, ERIE, PA 16509-3621
(814) 864-4867
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
07/28/2025
Last updated
07/28/2025
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