Organization
LIFECARE OF INDIANA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISAAC J LEESTMA (COO / ADMINISTRATOR)
(616) 821-3485
Entity
Organization
Contact information
Practice address
240 COMMERCE SQ, MICHIGAN CITY, IN 46360-3282
(219) 324-5005
Mailing address
240 COMMERCE SQ, MICHIGAN CITY, IN 46360-3282
(231) 299-2900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/23/2021
Last updated
07/22/2022
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