Organization Name: | LIFESPAN...A COMMUNITY SERVICE |
NPI Number: | 1093041576 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BARBARA FREYSINGER (CEO) |
Mailing Address: | 524 Lansing Ave Jackson |
State: | MI US |
Postal Code: | 492012804 |
Phone Number: | 5178170096 |
Fax Number: | 5177897883 |
NPI Enumeration Date: | 10/19/2009 |
NPI Last Update Date: | 10/19/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |