Provider Demographics
NPI:1427366467
Name:LIFECARE HOLDINGS, LLC
Entity Type:Organization
Organization Name:LIFECARE HOLDINGS, LLC
Other - Org Name:LIFESPRING HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:VAHLBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-329-4545
Mailing Address - Street 1:2102 N KICKAPOO AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-2721
Mailing Address - Country:US
Mailing Address - Phone:405-273-3344
Mailing Address - Fax:405-273-3348
Practice Address - Street 1:2411 SPRINGER DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-3955
Practice Address - Country:US
Practice Address - Phone:405-329-4545
Practice Address - Fax:405-310-3371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-23
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK377753Medicare Oscar/Certification