Healthcare Provider Details
I. General information
NPI: 1215753710
Provider Name (Legal Business Name): LCS-CNMI, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/29/2024
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
LCS-CNMI, INC., PMB 1293, 10001
SAIPAN MP
96950
US
IV. Provider business mailing address
PO BOX 10001
SAIPAN MP
96950-8901
US
V. Phone/Fax
- Phone: 670-785-5545
- Fax:
- Phone: 670-785-5545
- Fax: 909-906-1508
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANA
M
LORENZ-GREGOR
Title or Position: PRESIDENT & CEO
Credential: PH.D
Phone: 909-210-1068