Provider Demographics
NPI:1962490433
Name:REGIONAL HEALTH CARE PROFESSIONALS INC
Entity Type:Organization
Organization Name:REGIONAL HEALTH CARE PROFESSIONALS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FAHLBECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-295-9999
Mailing Address - Street 1:PO BOX 147
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46515-0147
Mailing Address - Country:US
Mailing Address - Phone:574-295-9999
Mailing Address - Fax:574-262-8888
Practice Address - Street 1:525 W BRISTOL ST
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-2964
Practice Address - Country:US
Practice Address - Phone:574-295-9999
Practice Address - Fax:574-262-8888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN04002407251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN157459Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER