Healthcare Provider Details

I. General information

NPI: 1003155748
Provider Name (Legal Business Name): LIONESS COMMUNITY CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2013
Last Update Date: 06/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PPG PL FL 31
PITTSBURGH PA
15222-5415
US

IV. Provider business mailing address

6425 LIVING PLACE SUITE 200
PITTSBURGH PA
15206
US

V. Phone/Fax

Practice location:
  • Phone: 412-712-6525
  • Fax:
Mailing address:
  • Phone: 412-712-6525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY EDWARDS COLEMAN
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 412-712-6525