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General NPI Number Information
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NPI Number | 1568526184
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Entity Type | Organization
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Legal Business Name | LIFECARE CORPORATION
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3510 SHERMAN ST
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City | HOUSTON
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State | TX
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Zip | 77003-2519
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Country | US
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Telephone | 713-224-5344
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2526
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City | HOUSTON
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State | TX
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Zip | 77252-2526
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | JACK P GAY
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Credential |
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Telephone | 713-222-0076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 111113
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License Number State | TX
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