Provider Demographics
NPI: | 1801485404 |
---|---|
Name: | VIECARE BUTLER, LLC |
Entity type: | Organization |
Organization Name: | VIECARE BUTLER, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CFO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JEFFREY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CARRAWAY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 724-742-2246 |
Mailing Address - Street 1: | 1323 FREEDOM RD |
Mailing Address - Street 2: | |
Mailing Address - City: | CRANBERRY TOWNSHIP |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 16066-5001 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 724-742-2231 |
Mailing Address - Fax: | 724-776-0815 |
Practice Address - Street 1: | 115 TECHNOLOGY DR |
Practice Address - Street 2: | |
Practice Address - City: | BUTLER |
Practice Address - State: | PA |
Practice Address - Zip Code: | 16001-1785 |
Practice Address - Country: | US |
Practice Address - Phone: | 724-431-3300 |
Practice Address - Fax: | 724-482-4331 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-01-18 |
Last Update Date: | 2021-01-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 314000000X | Nursing & Custodial Care Facilities | Skilled Nursing Facility | |
No | 313M00000X | Nursing & Custodial Care Facilities | Nursing Facility/Intermediate Care Facility |