Provider Demographics
NPI:1346081668
Name:LYONSABASERVICES
Entity type:Organization
Organization Name:LYONSABASERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TEDESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LYONS- PITTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:914-708-6398
Mailing Address - Street 1:19 BRONXVILLE RD APT 3S
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-6137
Mailing Address - Country:US
Mailing Address - Phone:914-708-6398
Mailing Address - Fax:
Practice Address - Street 1:19 BRONXVILLE RD APT 3S
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-6137
Practice Address - Country:US
Practice Address - Phone:914-708-6398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency