Healthcare Provider Details

I. General information

NPI: 1679916712
Provider Name (Legal Business Name): NEW LIFECARE HOSPITALS OF PITTSBURGH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2013
Last Update Date: 03/20/2015
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
PLANO TX
75024-3178
US

V. Phone/Fax

Practice location:
  • Phone: 412-734-6110
  • Fax: 412-734-7620
Mailing address:
  • Phone: 469-241-2128
  • Fax: 469-241-2177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number22980201
License Number StatePA

VIII. Authorized Official

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