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Organization

LIFECRAFT LLC

Active
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Organization

LIFECRAFT LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTY JO PUTNAM (MANAGER)
(269) 612-7222
Entity
Organization

Contact information

Practice address
515 LINCOLNWAY, LA PORTE, IN 46350-3363
(269) 612-7222
Mailing address
515 LINCOLNWAY, LA PORTE, IN 46350-3363
(269) 612-7222

Taxonomy

Speciality
Code
Description
License number
State
174H00000X
Health Educator
175T00000X
Peer Specialist
2255A2300X
Athletic Trainer
225800000X
Recreation Therapist
Primary
226000000X
Recreational Therapist Assistant

Other

Enumeration date
05/13/2021
Last updated
05/13/2021
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