Healthcare Provider Details

I. General information

NPI: 1366701146
Provider Name (Legal Business Name): RESCARE PA HEALTH MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2012
Last Update Date: 05/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 SUMNEYTOWN PIKE STE 105
SPRING HOUSE PA
19477-1011
US

IV. Provider business mailing address

4421 LORING ST
PHILA PA
19136-4015
US

V. Phone/Fax

Practice location:
  • Phone: 215-643-1200
  • Fax:
Mailing address:
  • Phone: 215-333-1735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberRN582712
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: LORI A. TEITELMAN
Title or Position: REGISTERED NURSE
Credential: R.N.
Phone: 215-333-1735