Provider Demographics
NPI:1508994153
Name:SYCAMORE REHABILITATION SERVICES-HCARC
Entity Type:Organization
Organization Name:SYCAMORE REHABILITATION SERVICES-HCARC
Other - Org Name:SYCAMORE SERVICES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:COCKRUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-745-4715
Mailing Address - Street 1:1100 W LLOYD EXPY
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47708-1146
Mailing Address - Country:US
Mailing Address - Phone:812-421-0847
Mailing Address - Fax:812-421-0849
Practice Address - Street 1:1100 W LLOYD EXPY
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47708-1146
Practice Address - Country:US
Practice Address - Phone:812-421-0847
Practice Address - Fax:812-421-0849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities