Provider Demographics
NPI:1144850264
Name:LSA VENTURES, LLC
Entity type:Organization
Organization Name:LSA VENTURES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLIENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MARGO
Authorized Official - Middle Name:
Authorized Official - Last Name:WEILL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:973-810-0110
Mailing Address - Street 1:75 S ORANGE AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1743
Mailing Address - Country:US
Mailing Address - Phone:973-810-0110
Mailing Address - Fax:973-810-0109
Practice Address - Street 1:75 S ORANGE AVE STE 203
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-1743
Practice Address - Country:US
Practice Address - Phone:973-810-0110
Practice Address - Fax:973-810-0109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care