Provider Demographics
NPI:1245535103
Name:LIFE SPRING HEALTH CARE INC
Entity type:Organization
Organization Name:LIFE SPRING HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:N
Authorized Official - Last Name:NGISHU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:817-263-7197
Mailing Address - Street 1:4953 SUNSET RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-4615
Mailing Address - Country:US
Mailing Address - Phone:817-263-7197
Mailing Address - Fax:817-886-2717
Practice Address - Street 1:4953 SUNSET RIDGE DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76123-4615
Practice Address - Country:US
Practice Address - Phone:817-263-7197
Practice Address - Fax:817-886-2717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-24
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health