Provider Demographics
NPI:1689829939
Name:LIFECARE HOMES, INC.
Entity Type:Organization
Organization Name:LIFECARE HOMES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/NURSE
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:HOECHERL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:414-241-5010
Mailing Address - Street 1:4405 S DEERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-9240
Mailing Address - Country:US
Mailing Address - Phone:262-782-6068
Mailing Address - Fax:262-827-2642
Practice Address - Street 1:4405 S DEERWOOD DR
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-9240
Practice Address - Country:US
Practice Address - Phone:262-782-6068
Practice Address - Fax:262-827-2642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-28
Last Update Date:2008-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness