Healthcare Provider Details

I. General information

NPI: 1770469868
Provider Name (Legal Business Name): LIFESPACE COMMUNITIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8100 HIGHWOOD DR
BLOOMINGTON MN
55438-1006
US

IV. Provider business mailing address

3501 OLYMPUS BLVD STE 300
DALLAS TX
75019-6292
US

V. Phone/Fax

Practice location:
  • Phone: 952-831-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS HARSHFIELD
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 515-288-5805