MEDICARE: LIFECARE GROUP, 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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1871872234
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFECARE GROUP, INC

Provider Business Mailing Address
First Line	:	5550 STERRETT PL
Second Line	:	SUITE 314
City	:	COLUMBIA
State	:	MD
Zip	:	21044-2611
Country	:	US
Telephone Number	:	410-910-9425
Fax Number	:

Provider Business Practice Location Address
First Line	:	5550 STERRETT PL STE 314
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-2628
Country	:	US
Telephone Number	:	410-910-9425
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	MR. MAX MINEVICH
Credential	:
Telephone Number	:	410-910-9425

Provider Enumeration Date	:	08/16/2011
Last Update Date	:	08/16/2011

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