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General NPI Number Information
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NPI Number | 1326611187
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Entity Type | Organization
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Legal Business Name | LIFESPRING INC
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Dates
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Enumeration Date | 07/20/2021
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Last Update Date | 07/20/2021
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Provider Practice Location Address
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Address Line | 1020 VINCENNES ST
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City | NEW ALBANY
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State | IN
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Zip | 47150-3148
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Country | US
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Telephone | 812-280-2080
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Fax |
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Provider Business Mailing Address
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Address Line | 460 SPRING ST
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-3452
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Country | US
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Telephone | 812-280-2080
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Fax |
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Authorized Official
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Title or Position | EVP COMMUNITY HEALTH INITIATIVES
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Name | ANNE KEENEY
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Credential | DRPH
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Telephone | 812-206-1362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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