Provider Demographics
NPI:1710182647
Name:VIECARE BUTLER, LLC
Entity Type:Organization
Organization Name:VIECARE BUTLER, LLC
Other - Org Name:LIFE-BUTLER COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADHC DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MANNS
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:724-650-2923
Mailing Address - Street 1:1323 FREEDOM RD
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-5001
Mailing Address - Country:US
Mailing Address - Phone:724-776-1100
Mailing Address - Fax:724-776-0811
Practice Address - Street 1:229 W DIAMOND ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-5784
Practice Address - Country:US
Practice Address - Phone:724-650-2923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization