Provider Demographics
NPI:1619906765
Name:LIFECARE HOSPITALS, INC
Entity Type:Organization
Organization Name:LIFECARE HOSPITALS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF REVENUE CYCLE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-241-2100
Mailing Address - Street 1:5560 TENNYSON PKWY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3532
Mailing Address - Country:US
Mailing Address - Phone:469-241-2100
Mailing Address - Fax:469-241-5198
Practice Address - Street 1:9320 LINWOOD AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-7003
Practice Address - Country:US
Practice Address - Phone:318-688-8504
Practice Address - Fax:318-671-6859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA332282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1761044Medicaid
LA1761044Medicaid