Organization
LIFE TOWN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CONNIE BROOKS (CEO)
(719) 200-6487
Entity
Organization
Contact information
Practice address
3970 LARDNER LANE, COLORADO SPRINGS, CO 80916-8091
(719) 299-6487
Mailing address
3970 LARDNER LN, COLORADO SPRINGS, CO 80916-2823
(719) 200-6487
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
11/26/2021
Last updated
10/14/2022
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