Organization
LACKAWANNA HEALTHCARE ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID W KLINGERMAN JR. (MEMBER)
(570) 204-8787
Entity
Organization
Contact information
Practice address
1301 BLOOM RD, DANVILLE, PA 17821-6532
(570) 284-4343
(570) 284-4346
Mailing address
1301 BLOOM RD, DANVILLE, PA 17821-6532
(570) 284-4343
(570) 284-4346
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03152020
—
PA
Enumeration date
08/27/2019
Last updated
08/30/2024
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