Provider Demographics
NPI:1538366026
Name:LIFESPACE COMMUNITIES INC
Entity type:Organization
Organization Name:LIFESPACE COMMUNITIES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE, AUDIT & PRIVACY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:NUTTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-309-7803
Mailing Address - Street 1:4201 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-5906
Mailing Address - Country:US
Mailing Address - Phone:515-288-5805
Mailing Address - Fax:
Practice Address - Street 1:210 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516
Practice Address - Country:US
Practice Address - Phone:630-769-6000
Practice Address - Fax:630-769-6020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy