Provider Demographics
NPI:1134152234
Name:LIFECARE HOSPITALS OF DAYTON INC
Entity type:Organization
Organization Name:LIFECARE HOSPITALS OF DAYTON INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF REIMBURSEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CRONIN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:469-241-2128
Mailing Address - Street 1:5340 LEGACY DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3121
Mailing Address - Country:US
Mailing Address - Phone:469-241-2100
Mailing Address - Fax:469-241-5198
Practice Address - Street 1:4000 MIAMISBURG CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-7615
Practice Address - Country:US
Practice Address - Phone:937-384-8300
Practice Address - Fax:937-384-8399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2010-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1439282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2279207Medicaid
OH2279207Medicaid