Basic Information
| Provider Information | |||||||||
| NPI: | 1629461686 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LEH OPERATING, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4711 GOLF ROAD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SKOIE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600761236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8479339280 | ||||||||
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| Practice Location | |||||||||
| Address1: | 151 9TH AVE | ||||||||
| Address2: | |||||||||
| City: | LITTLE EGG HARBOR TWP | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080874218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6092943200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2015 | ||||||||
| LastUpdateDate: | 03/13/2015 | ||||||||
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| AuthorizedOfficialLastName: | GUTNICKI | ||||||||
| AuthorizedOfficialFirstName: | ABRAHAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8479339280 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.