Provider Demographics
NPI:1477087401
Name:RCA OUTPATIENT SERVICES LLC
Entity Type:Organization
Organization Name:RCA OUTPATIENT SERVICES LLC
Other - Org Name:RCA AT DELAWARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE DIRECTOR, PATIENT ACCOUNT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLIHUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-994-2968
Mailing Address - Street 1:2701 RENAISSANCE BLVD
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2781
Mailing Address - Country:US
Mailing Address - Phone:610-994-2968
Mailing Address - Fax:
Practice Address - Street 1:RECOVERY CENTERS OF AMERICA AT DELAWARE
Practice Address - Street 2:2383 LIMESTONE ROAD
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808
Practice Address - Country:US
Practice Address - Phone:610-994-2968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRC-OC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-17
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health