Healthcare Provider Details

I. General information

NPI: 1881000511
Provider Name (Legal Business Name): LAURENCY OPTIMAL PERSONAL CARE AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2014
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 S FRANKLIN ST SUITE 4
WILKES BARRE PA
18701-1104
US

IV. Provider business mailing address

136 S FRANKLIN ST SUITE 4
WILKES BARRE PA
18701-1104
US

V. Phone/Fax

Practice location:
  • Phone: 570-235-6504
  • Fax: 570-235-6898
Mailing address:
  • Phone: 570-235-6504
  • Fax: 570-235-6898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number25383601
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. HELENA LAURENCY
Title or Position: PRESIDENT-CEO
Credential:
Phone: 570-235-6504