NPIMap

Organization Active NPI

LCH Health and Community Services

  • Federally Qualified Health Center (FQHC)
  • West Grove, PA
National Provider Identifier
1699305375
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LCH HEALTH AND COMMUNITY SERVICES
Practice address
105 Vineyard Way Ste 103
West Grove, PA 19390-8849
Phone
(610) 444-7550
Fax
(610) 444-4656
NPI assigned
Jan 22, 2020
Last updated
Jun 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Melody Caulfield
Title
Compliance & Accreditation Admin
Phone
(610) 444-7550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

105 Vineyard Way Ste 103
West Grove, PA 19390-8849

Mailing address

731 W Cypress St
Kennett Square, PA 19348-2419
Phone (610) 444-7550

Other identifiers 1

IdentifierTypeStateIssuer
100752680-0012MedicaidPA

Other names 1

  • La Comunidad Hispana, Inc Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050310000620 PA Part B Supplier - Clinic/Group Practice 2466406574 Receives reassigned benefits from 27 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kennett Square, PA; Oxford, PA; West Grove, PA
O20200329000592 PA Part A Provider - Federally Qualified Health Center (FQHC) 2466406574 Practice locations: West Grove, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699305375. Details of each certification follow.

Federally qualified health center certification: CCN 391196

Legal name
LCH HEALTH AND COMMUNITY SERVICES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 25, 2020
Last certification
Mar 25, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 19, 1980 in PA
Enrollment address
105 Vineyard Way
Ste 103
West Grove, PA 19390-8849

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
LCH Health and Community Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ronan Gannon Individual Corporate OfficerCeo May 1, 2021
W-2 Managing EmployeeCeo May 1, 2021
Operational/Managerial ControlCeo May 1, 2021

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
LCH Health and Community ServicesOxford, PA, CCN 731876 Federally qualified health center 5% Or Greater Direct Ownership Interest
Other		 May 1, 1980
May 1, 1980

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1699305375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 W CYPRESS ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193482419",
            "telephone_number": "610-444-7550",
            "fax_number": "610-444-4656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 VINEYARD WAY STE 103",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193908849",
            "telephone_number": "610-444-7550",
            "fax_number": "610-444-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LCH HEALTH AND COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-22",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "CAULFIELD",
        "authorized_official_first_name": "MELODY",
        "authorized_official_title_or_position": "COMPLIANCE & ACCREDITATION ADMIN",
        "authorized_official_telephone_number": "610-444-7550"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100752680-0012",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Comunidad Hispana, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in West Grove, PA

Sources for this page

Verify at the official NPI Registry.