Organization
LIFESPRING, INC
Active
Organization
LIFESPRING, INC
Active
Parent organization
LIFESPRING, INC.
Other names
Lifespring Community Medical Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFESPRING, INC.
Authorized official
MR. TERRY LYNN STAWAR ED.D (CEO)
(812) 206-1234
Entity
Organization
Contact information
Practice address
1036 SHARON DR, JEFFERSONVILLE, IN 47130-4522
(812) 280-2080
Mailing address
1036 SHARON DR, JEFFERSONVILLE, IN 47130-4522
(812) 280-2080
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
151959
PTAN
IN
Enumeration date
05/28/2015
Last updated
12/20/2023
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