Provider Demographics
NPI:1871872234
Name:LIFECARE GROUP, INC
Entity type:Organization
Organization Name:LIFECARE GROUP, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MAX
Authorized Official - Middle Name:
Authorized Official - Last Name:MINEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-910-9425
Mailing Address - Street 1:5550 STERRETT PL
Mailing Address - Street 2:SUITE 314
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-2611
Mailing Address - Country:US
Mailing Address - Phone:410-910-9425
Mailing Address - Fax:
Practice Address - Street 1:5550 STERRETT PL STE 314
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2628
Practice Address - Country:US
Practice Address - Phone:410-910-9425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health