Provider Demographics
NPI:1396753091
Name:LIFESPAN RESOURCES
Entity type:Organization
Organization Name:LIFESPAN RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-948-8330
Mailing Address - Street 1:PO BOX 995
Mailing Address - Street 2:426 BANK ST STE 100
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47151-0995
Mailing Address - Country:US
Mailing Address - Phone:812-948-8330
Mailing Address - Fax:812-941-5778
Practice Address - Street 1:426 BANK ST STE 100
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-3456
Practice Address - Country:US
Practice Address - Phone:812-948-8330
Practice Address - Fax:812-941-5778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN2000274820A332U00000X
INUSDOT1382548IN343900000X
IN251B00000X, 251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332U00000XSuppliersHome Delivered Meals
Not Answered343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Not Answered251B00000XAgenciesCase Management