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General NPI Number Information
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NPI Number | 1245535103
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Entity Type | Organization
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Legal Business Name | LIFE SPRING HEALTH CARE INC
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Dates
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Enumeration Date | 01/24/2011
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Last Update Date | 09/10/2012
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Provider Practice Location Address
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Address Line | 4953 SUNSET RIDGE DR
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City | FORT WORTH
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State | TX
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Zip | 76123-4615
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Country | US
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Telephone | 817-263-7197
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Fax | 817-886-2717
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Provider Business Mailing Address
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Address Line | 4953 SUNSET RIDGE DR
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City | FORT WORTH
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State | TX
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Zip | 76123-4615
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Country | US
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Telephone | 817-263-7197
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Fax | 817-886-2717
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ROSE N NGISHU
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Credential | RN
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Telephone | 817-263-7197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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