Basic Information
Provider Information
NPI: 1386018166
EntityType: 2
ReplacementNPI:  
OrganizationName: LIFECARE BEHAVIORAL HEALTH HOSPITAL OF PITTSBURGH LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: LIFECARE BEHAVIORAL HEALTH HOSPITAL
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5340 LEGACY DR
Address2: SUIE150
City: PLANO
State: TX
PostalCode: 750243178
CountryCode: US
TelephoneNumber: 4692412128
FaxNumber: 4692412177
Practice Location
Address1: 225 PENN AVE
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152212173
CountryCode: US
TelephoneNumber: 4122472424
FaxNumber: 4122472333
Other Information
ProviderEnumerationDate: 11/17/2015
LastUpdateDate: 12/09/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: CRONIN
AuthorizedOfficialFirstName: JOHN
AuthorizedOfficialMiddleName: MICHAEL
AuthorizedOfficialTitleorPosition: VICE PRESIDENT - REIMBURSEMENT
AuthorizedOfficialTelephone: 4692412128
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
283Q00000X  Y HospitalsPsychiatric Hospital 

No ID Information.


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