=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952557324
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LIFE CARE SOLUTIONS, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/17/2008
-----------------------------------------------------
Last Update Date | 08/17/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2385 SHERWOOD FOREST DR
-----------------------------------------------------
City | NASHVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47448-9725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-988-6830
-----------------------------------------------------
Fax | 812-988-2040
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2385 SHERWOOD FOREST DR
-----------------------------------------------------
City | NASHVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47448-9725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-988-6830
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | HAROLD CAMERON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 812-988-6830
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 08-011721-1
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------