Healthcare Provider Details

I. General information

NPI: 1073478673
Provider Name (Legal Business Name): LIFESPRING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 PLEASANT VILLA AVE
BALTIMORE MD
21228-4004
US

IV. Provider business mailing address

2200 PLEASANT VILLA AVE
BALTIMORE MD
21228-4004
US

V. Phone/Fax

Practice location:
  • Phone: 443-673-4358
  • Fax: 410-744-2724
Mailing address:
  • Phone: 443-673-4358
  • Fax: 410-744-2724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. KRISTEN WHITE
Title or Position: MANAGING MEMBER
Credential:
Phone: 443-673-4358