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Organization
LIFESPAN HEALTH SERVICE INC
Active
Organization
LIFESPAN HEALTH SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH REBEL NOBLE R.N., B.S.N., D.T.S. (CEO)
(765) 426-1425
Entity
Organization
Contact information
Practice address
2111 KLONDIKE RD, WEST LAFAYETTE, IN 47906-5124
(765) 274-2168
Mailing address
2111 KLONDIKE RD, WEST LAFAYETTE, IN 47906-5124
(765) 274-2168
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
28161533A
IN
Other
Enumeration date
06/02/2010
Last updated
06/02/2010
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