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NPI Code Detail

MEDICARE: LIFESPAN, INC

MEDICARE: LIFESPAN, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1366410813
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFESPAN, INC
Provider Business Mailing Address
First Line : 1900 FAIRGROVE AVE
Second Line :
City : HAMILTON
State : OH
Zip : 45011-1966
Country : US
Telephone Number : 513-868-3210
Fax Number : 513-868-3249
Provider Business Practice Location Address
First Line : 1900 FAIRGROVE AVE
Second Line :
City : HAMILTON
State : OH
Zip : 45011-1966
Country : US
Telephone Number : 513-868-3210
Fax Number : 513-868-3249
Authorized Official
Title or Position : CEO
Name : CYNTHIA STEVER
Credential : PHD
Telephone Number : 513-868-3210
Provider Enumeration Date : 03/10/2006
Last Update Date : 07/10/2007

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Directions to “LIFESPAN, INC ” Practice Location

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