Organization
LIFECARE FAMILY SERVICES
Active
Organization
LIFECARE FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANDON KENT MAUCK (HR COORDINATER)
(615) 781-0013
Entity
Organization
Contact information
Practice address
103 JV MANGUBAT DR, MEDICAL OFFICE-SUITE C, WAYNESBORO, TN 38485-2440
(615) 781-0013
Mailing address
103 JV MANGUBAT DR, MEDICAL OFFICE-SUITE C, WAYNESBORO, TN 38485-2440
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
TN
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3376955
—
TN
Enumeration date
08/22/2011
Last updated
08/22/2011
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