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NPI Code Detail

MEDICARE: LIFE CARE CENTERS OF AMERICA, INC.

MEDICARE: LIFE CARE CENTERS OF AMERICA, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing FacilityOR385120OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083669105
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFE CARE CENTERS OF AMERICA, INC.
Provider Business Mailing Address
First Line : 3001 KEITH ST NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37312-3713
Country : US
Telephone Number : 423-473-5751
Fax Number : 423-339-8342
Provider Business Practice Location Address
First Line : 2300 WARREN ST
Second Line :
City : EUGENE
State : OR
Zip : 97405-1116
Country : US
Telephone Number : 541-686-2828
Fax Number : 541-686-9093
Authorized Official
Title or Position : ASSISTANT SECRETARY
Name : CINDY S. CROSS
Credential :
Telephone Number : 423-473-5867
Provider Enumeration Date : 05/24/2006
Last Update Date : 09/15/2021

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Directions to “LIFE CARE CENTERS OF AMERICA, INC. ” Practice Location

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