Organization
LIFESTYLE SUPPORT SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATIE A DELOZIER (FINANCE IT MANAGER)
(814) 948-6708
Entity
Organization
Contact information
Practice address
1109 DEVEAUX STREET, ELMORA, PA 15714-0303
(814) 948-6708
(814) 948-6718
Mailing address
1109 DEVEAUX STREET, PO BOX 303, ELMORA, PA 15714-0303
(814) 948-6708
(814) 948-6718
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
—
PA
Other
Enumeration date
04/04/2007
Last updated
08/22/2020
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