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General NPI Number Information
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NPI Number | 1720788540
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Entity Type | Organization
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Legal Business Name | LIFECARE HOMES, LLC
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Dates
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Enumeration Date | 03/09/2023
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Last Update Date | 03/09/2023
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Provider Practice Location Address
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Address Line | 4013 S 119TH STREET
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City | GREENFIELD
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State | WI
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Zip | 53228
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Country | US
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Telephone | 262-888-2599
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Fax | 414-892-4970
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Provider Business Mailing Address
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Address Line | 806 CHURCH ST UNIT 1
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City | ALLENTON
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State | WI
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Zip | 53002
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Country | US
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Telephone | 262-888-2599
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Fax | 414-892-4970
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Authorized Official
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Title or Position | MEMBER
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Name | RACHEL SCHNEIDER
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Credential |
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Telephone | 636-734-4327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State |
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