| NPI | 1043570443 |
|---|---|
| Doing Business As | LECOM INSTITUE FOR SUCCESSFUL AGING |
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE VP Ops 858-964-1506 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: PA OS014134) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2014-06-13 |