Organization Active NPI

Lebanon

  • PACE Provider Organization
  • Lebanon, PA
National Provider Identifier
1871428474
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
LEBANON
Practice address
113 S 9TH St
Lebanon, PA 17042-5108
Phone
(717) 376-1133
NPI assigned
Jun 15, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Authorized official

Name
Ryan Leahy
Title
Chief Financial Officer
Phone
(845) 235-6531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X Primary

Addresses

Primary practice location

113 S 9TH St
Lebanon, PA 17042-5108

Mailing address

225 Crossways Park Dr
Woodbury, NY 11797-2083

National Provider Directory

National Provider Directory

Locations

225 Crossways Park Dr
Woodbury, NY 11797
Phone (516) 422-7817

NPI Registry JSON

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

{
    "created_epoch": "1781481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781481600000",
    "number": "1871428474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CROSSWAYS PARK DR",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117972083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 S 9TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170425108",
            "telephone_number": "717-376-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEBANON",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-15",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A",
        "authorized_official_last_name": "LEAHY",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "845-235-6531"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; 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.