Healthcare Provider Details

I. General information

NPI: 1437401635
Provider Name (Legal Business Name): LIFETOUCH MINISTRIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2012
Last Update Date: 10/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2426 EAST PIERCETON ROAD
WINONA LAKE IN
46590-5713
US

IV. Provider business mailing address

2426 EAST PIERCETON ROAD
WINONA LAKE IN
46590-5713
US

V. Phone/Fax

Practice location:
  • Phone: 574-269-7990
  • Fax: 574-269-7991
Mailing address:
  • Phone: 574-269-7990
  • Fax: 574-269-7991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY THOMAS FRANCE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 574-269-7990