Organization
LEGACY LIFELINE LLC
Active
Other names
Lifeline Legacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KIA BULLOCK (CEO)
(317) 998-5309
Entity
Organization
Contact information
Practice address
7230 ARBUCKLE CMNS STE 111, BROWNSBURG, IN 46112-1792
(219) 902-7508
Mailing address
7230 ARBUCKLE CMNS STE 111, BROWNSBURG, IN 46112-1792
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/20/2025
Last updated
11/06/2025
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