Basic Information
| Provider Information | |||||||||
| NPI: | 1366701146 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | RESCARE PA HEALTH MANAGEMENT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4421 LORING ST | ||||||||
| Address2: | |||||||||
| City: | PHILA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191364015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153331735 | ||||||||
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| Practice Location | |||||||||
| Address1: | 909 SUMNEYTOWN PIKE STE 105 | ||||||||
| Address2: | |||||||||
| City: | SPRING HOUSE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194771011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156431200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2012 | ||||||||
| LastUpdateDate: | 05/14/2012 | ||||||||
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| AuthorizedOfficialLastName: | TEITELMAN | ||||||||
| AuthorizedOfficialFirstName: | LORI | ||||||||
| AuthorizedOfficialMiddleName: | A. | ||||||||
| AuthorizedOfficialTitleorPosition: | REGISTERED NURSE | ||||||||
| AuthorizedOfficialTelephone: | 2153331735 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | RESCARE PA HEALTH MANAGEMENT | ||||||||
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| AuthorizedOfficialCredential: | R.N. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251J00000X | RN582712 | PA | Y | Agencies | Nursing Care |
No ID Information.