Healthcare Provider Details

I. General information

NPI: 1164713236
Provider Name (Legal Business Name): LIFECARE HOSPITALS OF PITTSBURGH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2011
Last Update Date: 11/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S JACKSON AVE
PITTSBURGH PA
15202-3428
US

IV. Provider business mailing address

5340 LEGACY DR SUITE 150, BLDG 4
PLANO TX
75024-3178
US

V. Phone/Fax

Practice location:
  • Phone: 412-734-7600
  • Fax: 412-734-7697
Mailing address:
  • Phone: 469-241-2100
  • Fax: 469-241-2177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN MICHAEL CRONIN
Title or Position: VICE PRESIDENT OF REIMBURSEMENT
Credential: CPA
Phone: 469-241-2128