1427366467 NPI number — LIFECARE HOLDINGS, LLC

Table of content: (NPI 1427366467)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427366467 NPI number — LIFECARE HOLDINGS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LIFECARE HOLDINGS, 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:
1427366467
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2102 N KICKAPOO AVE
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
SHAWNEE
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74804-2721
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-273-3344
Provider Business Mailing Address Fax Number:
405-273-3348

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2411 SPRINGER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORMAN
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73069-3955
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-329-4545
Provider Business Practice Location Address Fax Number:
405-310-3371
Provider Enumeration Date:
09/23/2010

Additional Information

Authorized Official

Authorized Official Last Name:
VAHLBERG
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
ELAINE
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
405-329-4545

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com