MEDICARE: RESIDENTIAL CARE SERVICES, 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
1	320800000X	Mental Illness Community Based Residential Treatment Facility	471000	PA

General Provider Information

NPI Number	:	1639335631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESIDENTIAL CARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	2400 ARDMORE BLVD
Second Line	:	SUITE 601
City	:	PITTSBURGH
State	:	PA
Zip	:	15221-5299
Country	:	US
Telephone Number	:	412-271-2990
Fax Number	:	412-271-2947

Provider Business Practice Location Address
First Line	:	2400 ARDMORE BLVD
Second Line	:	SUITE 601
City	:	PITTSBURGH
State	:	PA
Zip	:	15221-5299
Country	:	US
Telephone Number	:	412-271-2990
Fax Number	:	412-271-2947

Authorized Official
Title or Position	:	ASSISTANT EXECUTIVE DIRECTOR/CFO
Name	:	MR. THOMAS M CLOHERTY
Credential	:
Telephone Number	:	412-271-2990

Provider Enumeration Date	:	07/30/2008
Last Update Date	:	07/30/2008

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