Provider Demographics
| NPI: | 1801485404 |
|---|---|
| Name: | VIECARE BUTLER, LLC |
| Entity type: | Organization |
| Organization Name: | VIECARE BUTLER, LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CFO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | JEFFREY |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | CARRAWAY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 724-742-2246 |
| 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: | 724-742-2231 |
| Mailing Address - Fax: | 724-776-0815 |
| Practice Address - Street 1: | 115 TECHNOLOGY DR |
| Practice Address - Street 2: | |
| Practice Address - City: | BUTLER |
| Practice Address - State: | PA |
| Practice Address - Zip Code: | 16001-1785 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 724-431-3300 |
| Practice Address - Fax: | 724-482-4331 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2021-01-18 |
| Last Update Date: | 2021-01-18 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 314000000X | Nursing & Custodial Care Facilities | Skilled Nursing Facility | |
| No | 313M00000X | Nursing & Custodial Care Facilities | Nursing Facility/Intermediate Care Facility |