Organization
LIFECARE ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES GEHRING (PRESIDENT/CEO)
(614) 278-3130
Entity
Organization
Contact information
Practice address
1699 W MOUND ST, COLUMBUS, OH 43223-1809
(614) 278-3130
(614) 278-3143
Mailing address
1699 W MOUND ST, COLUMBUS, OH 43223-1809
(614) 278-3130
(614) 278-3143
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
412300
MEDICAID PASSPORT
OH
Enumeration date
04/09/2008
Last updated
03/01/2012
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