Basic Information
| Provider Information | |||||||||
| NPI: | 1518041102 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SENIORCARE ASSOCIATES LP | ||||||||
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| OtherOrganizationName: | BAYLOR INSTITUTE FOR REHABILITATION HOME HEALTH SERVICES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1241 CROSS TIMBERS RD | ||||||||
| Address2: | |||||||||
| City: | FLOWER MOUND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750281272 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9726913131 | ||||||||
| FaxNumber: | 9726913151 | ||||||||
| Practice Location | |||||||||
| Address1: | 4714 GETTYSBURG RD | ||||||||
| Address2: | |||||||||
| City: | MECHANICSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170554325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7179721100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2006 | ||||||||
| LastUpdateDate: | 02/16/2016 | ||||||||
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| AuthorizedOfficialLastName: | BICKELHAUPT | ||||||||
| AuthorizedOfficialFirstName: | SCOTT | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICAL THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 9726913131 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | BIR JV, LLP | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | 009558 | TX | Y | Agencies | Home Health |
No ID Information.