NPIMap

Organization Active NPI

Lecom Senior Living Center

  • Nutrition Education Nutritionist
  • Erie, PA
National Provider Identifier
1891237665
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Education NutritionistTaxonomy code 133NN1002X
License
806473
Legal business name
LECOM SENIOR LIVING CENTER
Practice address
5535 Peach Street
Erie, PA 16509-8528
Phone
(814) 868-3820
Fax
(814) 868-3887
NPI assigned
Nov 10, 2016
Organization subpart
Yes
Parent organization
MILLCREEK MANORAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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

Authorized official

Name
Dr. Melanie Rae Titzel, PH.D.
Title
Director of Operations
Phone
81486833812

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education NutritionistGroup: 193400000X SINGLE SPECIALTY GROUP 133NN1002X 806473 Primary

Addresses

Primary practice location

5535 Peach Street
Erie, PA 16509-8528

Mailing address

5535 Peach Street
Erie, PA 16509-8528
Phone (814) 868-3820

Other names 1

  • Millcreek Manor Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Millcreek Manor12 organizations share this tax ID, including this one
Part of
Millcreek Manor

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1478736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478736000000",
    "number": "1891237665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 PEACH STREET",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165098528",
            "telephone_number": "814-868-3820",
            "fax_number": "814-868-3887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 PEACH STREET",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165098528",
            "telephone_number": "814-868-3820",
            "fax_number": "814-868-3887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LECOM SENIOR LIVING CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MILLCREEK MANOR",
        "enumeration_date": "2016-11-10",
        "last_updated": "2016-11-10",
        "status": "A",
        "authorized_official_last_name": "TITZEL",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "81486833812",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": "806473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Millcreek Manor",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; 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.