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General NPI Number Information
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NPI Number | 1497731467
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Entity Type | Organization
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Legal Business Name | GREATER LEHIGH VALLEY VISITING NURSE ASSOCIATION, INC.
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Dates
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Enumeration Date | 12/21/2005
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 501 N 17TH ST SUITE 200
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City | ALLENTOWN
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State | PA
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Zip | 18104-5044
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Country | US
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Telephone | 610-395-2500
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Fax | 610-432-1675
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Provider Business Mailing Address
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Address Line | 1170 BERKSHIRE BLVD
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City | WYOMISSING
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State | PA
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Zip | 19610-1215
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Country | US
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Telephone | 610-378-0481
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Fax | 610-378-9762
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. LUCILLE D GOUGH
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Credential | RN, MSN, MBA
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Telephone | 610-378-0481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 758405
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License Number State | PA
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