Provider Demographics
NPI:1902231954
Name:LIFECARE
Entity Type:Organization
Organization Name:LIFECARE
Other - Org Name:WHEELING CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:R
Authorized Official - Last Name:AQUINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-420-0988
Mailing Address - Street 1:51520 NATIONAL RD E
Mailing Address - Street 2:SUITE 8
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-8213
Mailing Address - Country:US
Mailing Address - Phone:740-296-5711
Mailing Address - Fax:740-296-5712
Practice Address - Street 1:51520 NATIONAL RD E
Practice Address - Street 2:SUITE 8
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-8213
Practice Address - Country:US
Practice Address - Phone:740-296-5711
Practice Address - Fax:740-296-5712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies