Organization
LIFESPAN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN G. MOORE MD (PRESIDENT/CEO)
(812) 332-2265
Entity
Organization
Contact information
Practice address
800 BELL TRACE CIR, BLOOMINGTON, IN 47408-4405
(812) 335-2445
(812) 353-7576
Mailing address
3749 E. COVENANTER DRIVE, BLOOMINGTON, IN 47401-5454
(812) 332-2265
(812) 334-0853
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
001614-1
IN
Other
Enumeration date
03/23/2006
Last updated
08/22/2020
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