Organization
LIFECARE FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANDON MAUCK (HR DIRECTOR)
(615) 781-0013
Entity
Organization
Contact information
Practice address
2971 FORT HENRY DR, KINGSPORT, TN 37664-4005
(615) 781-0013
Mailing address
2971 FORT HENRY DR, KINGSPORT, TN 37664-4005
(615) 781-0013
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3376955
—
TN
Enumeration date
08/15/2013
Last updated
08/15/2013
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