Organization
LIFECARE FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANDON KENT MAUCK BBA (HR COORDINATOR)
(615) 781-0013
Entity
Organization
Contact information
Practice address
1911 MICHIGAN AVENUE, JAMESTOWN, TN 38556
(931) 879-9980
(931) 879-9988
Mailing address
1911 MICHIGAN AVENUE, JAMESTOWN, TN 38556
(931) 879-9980
(931) 879-9988
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6060
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3376955
GROUP MEDICARE
TN
Enumeration date
03/08/2010
Last updated
03/08/2010
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