MEDICARE: LIFETOUCH MINISTRIES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1437401635
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFETOUCH MINISTRIES, INC.

Provider Business Mailing Address
First Line	:	2426 EAST PIERCETON ROAD
Second Line	:
City	:	WINONA LAKE
State	:	IN
Zip	:	46590-5713
Country	:	US
Telephone Number	:	574-269-7990
Fax Number	:	574-269-7991

Provider Business Practice Location Address
First Line	:	2426 EAST PIERCETON ROAD
Second Line	:
City	:	WINONA LAKE
State	:	IN
Zip	:	46590-5713
Country	:	US
Telephone Number	:	574-269-7990
Fax Number	:	574-269-7991

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. JEFFREY THOMAS FRANCE
Credential	:
Telephone Number	:	574-269-7990

Provider Enumeration Date	:	10/11/2012
Last Update Date	:	10/28/2013

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