Organization
LIFE SPAN HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH SOUTHORN MACP (EXECUTIVE DIRECTOR)
(916) 965-0110
Entity
Organization
Contact information
Practice address
4041 BRIDGE STREET, FAIR OAKS, CA 95628
(916) 965-0110
(916) 965-0102
Mailing address
4041 BRIDGE STREET, FAIR OAKS, CA 95628
(916) 965-0110
(916) 965-0102
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/02/2015
Last updated
01/02/2015
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