Provider Demographics
NPI:1427888643
Name:LUMOS RECOVERY, LLC
Entity type:Organization
Organization Name:LUMOS RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-516-1793
Mailing Address - Street 1:4950 WILSON LN
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-4442
Mailing Address - Country:US
Mailing Address - Phone:917-816-5353
Mailing Address - Fax:
Practice Address - Street 1:31 S MILL ST
Practice Address - Street 2:
Practice Address - City:EAST YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-2515
Practice Address - Country:US
Practice Address - Phone:717-573-7973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUMOS RECOVERY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health