Organization
LIFESPAN HEALTH SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH REBEL NOBLE R.N., B.S.N., D.T.S. (CEO)
(765) 426-1425
Entity
Organization
Contact information
Practice address
2111 KLONDIKE RD, WEST LAFAYETTE, IN 47906-5124
(765) 274-2168
Mailing address
2111 KLONDIKE RD, WEST LAFAYETTE, IN 47906-5124
(765) 274-2168
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
28161533A
IN
Other
Enumeration date
06/02/2010
Last updated
06/02/2010
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