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NPI Code Detail

MEDICARE: LIFE CARE CENTERS OF AMERICA, INC.

MEDICARE: LIFE CARE CENTERS OF AMERICA, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility164TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295777894
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFE CARE CENTERS OF AMERICA, INC.
Provider Business Mailing Address
First Line : 3001 KEITH ST NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37312-3713
Country : US
Telephone Number : 423-473-5751
Fax Number : 423-339-8342
Provider Business Practice Location Address
First Line : 1234 FRYE ST
Second Line :
City : ATHENS
State : TN
Zip : 37303-3052
Country : US
Telephone Number : 423-745-8181
Fax Number : 423-745-9257
Authorized Official
Title or Position : ASSISTANT SECRETARY
Name : CINDY S CROSS
Credential :
Telephone Number : 423-473-5867
Provider Enumeration Date : 06/11/2006
Last Update Date : 09/15/2021

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Directions to “LIFE CARE CENTERS OF AMERICA, INC. ” Practice Location

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