Provider Demographics
NPI:1366701146
Name:RESCARE PA HEALTH MANAGEMENT
Entity type:Organization
Organization Name:RESCARE PA HEALTH MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:A
Authorized Official - Last Name:TEITELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:215-333-1735
Mailing Address - Street 1:4421 LORING ST
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19136-4015
Mailing Address - Country:US
Mailing Address - Phone:215-333-1735
Mailing Address - Fax:
Practice Address - Street 1:909 SUMNEYTOWN PIKE STE 105
Practice Address - Street 2:
Practice Address - City:SPRING HOUSE
Practice Address - State:PA
Practice Address - Zip Code:19477-1011
Practice Address - Country:US
Practice Address - Phone:215-643-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESCARE PA HEALTH MANAGEMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN582712251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care