Healthcare Provider Details

I. General information

NPI: 1467449348
Provider Name (Legal Business Name): LORE CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 07/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 W GRANDVIEW BLVD
ERIE PA
16509-1507
US

IV. Provider business mailing address

860 W. GRANDVIEW BLVD
ERIE PA
16509
US

V. Phone/Fax

Practice location:
  • Phone: 814-866-6748
  • Fax:
Mailing address:
  • Phone: 814-866-6748
  • Fax: 814-438-2229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310500000X
TaxonomyMental Illness Intermediate Care Facility
License NumberRP026081L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License NumberRP026081L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License NumberRP026081L
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License NumberRP026081L
License Number StatePA

VIII. Authorized Official

Name: MRS. LORETTA JEAN PATTON
Title or Position: OWNER
Credential: RPH
Phone: 814-866-6748