NPIMap

Organization Active NPI

Life Care Centers of America, Inc.

Doing business as Las Fuentes Rehabilitation Center

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Prescott, AZ
National Provider Identifier
1326376369
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
License
OTC4668 Issued in AZ
Legal business name
LIFE CARE CENTERS OF AMERICA, INC.
Doing business as
Las Fuentes Rehabilitation Center
Practice address
1045 Scott Dr
Prescott, AZ 86301-1731
Phone
(928) 778-9603
Fax
(928) 778-5909
NPI assigned
Dec 3, 2009
Last updated
Sep 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cindy Cross
Title
Assistant Secretary
Phone
(423) 473-5867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X OTC4668 AZ Primary

Addresses

Primary practice location

1045 Scott Dr
Prescott, AZ 86301-1731

Mailing address

3001 Keith St NW
Cleveland, TN 37312-3713
Phone (423) 473-5751

Other names 1

  • Las Fuentes Rehabilitation Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Life Care Centers of America Inc28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1259798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631664000000",
    "number": "1326376369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 KEITH ST NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123713",
            "telephone_number": "423-473-5751",
            "fax_number": "423-339-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 SCOTT DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011731",
            "telephone_number": "928-778-9603",
            "fax_number": "928-778-5909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CARE CENTERS OF AMERICA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-03",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "423-473-5867"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "AZ",
            "license": "OTC4668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Las Fuentes Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.