Lifestyle Support Services Inc

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

Legal business name

LIFESTYLE SUPPORT SERVICES INC

Practice address

1109 Deveaux Street
Elmora, PA 15714-0303

Phone

(814) 948-6708

Fax

(814) 948-6718

NPI assigned

Apr 4, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Katie A Delozier

Title

Finance It Manager

Phone

(814) 948-6708

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821110669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 DEVEAUX STREET",
            "address_2": "PO BOX 303",
            "city": "ELMORA",
            "state": "PA",
            "postal_code": "157140303",
            "telephone_number": "814-948-6708",
            "fax_number": "814-948-6718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 DEVEAUX STREET",
            "city": "ELMORA",
            "state": "PA",
            "postal_code": "157140303",
            "telephone_number": "814-948-6708",
            "fax_number": "814-948-6718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE SUPPORT SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DELOZIER",
        "authorized_official_first_name": "KATIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "FINANCE IT MANAGER",
        "authorized_official_telephone_number": "814-948-6708",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.