1386018166 NPI number — LIFECARE BEHAVIORAL HEALTH HOSPITAL OF PITTSBURGH LLC

Table of content: (NPI 1386018166)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386018166 NPI number — LIFECARE BEHAVIORAL HEALTH HOSPITAL OF PITTSBURGH LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LIFECARE BEHAVIORAL HEALTH HOSPITAL OF PITTSBURGH LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386018166
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/09/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5340 LEGACY DR
Provider Second Line Business Mailing Address:
SUIE150
Provider Business Mailing Address City Name:
PLANO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75024-3178
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-241-2128
Provider Business Mailing Address Fax Number:
469-241-2177

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
225 PENN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15221-2173
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-247-2424
Provider Business Practice Location Address Fax Number:
412-247-2333
Provider Enumeration Date:
11/17/2015

Additional Information

Authorized Official

Authorized Official Last Name:
CRONIN
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
VICE PRESIDENT - REIMBURSEMENT
Authorized Official Telephone Number:
469-241-2128

Provider Taxonomy Codes

  • Taxonomy code: 283Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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