Provider Demographics
NPI:1750506614
Name:LEBANON COUNTY COMMISSIONERS
Entity type:Organization
Organization Name:LEBANON COUNTY COMMISSIONERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:KLARSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-274-0427
Mailing Address - Street 1:220 E LEHMAN ST
Mailing Address - Street 2:LEBANON CO DRUG AND ALCOHOL
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17046-3930
Mailing Address - Country:US
Mailing Address - Phone:717-274-0427
Mailing Address - Fax:717-274-0420
Practice Address - Street 1:220 E LEHMAN ST
Practice Address - Street 2:LEBANON CO DRUG AND ALCOHOL
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17046-3930
Practice Address - Country:US
Practice Address - Phone:717-274-0427
Practice Address - Fax:717-274-0420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000048620019Medicaid
PA1000048620018Medicaid