Provider Demographics
NPI:1114070885
Name:LIFECARE FAMILY SERVICES INC
Entity Type:Organization
Organization Name:LIFECARE FAMILY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:KUSCHEL
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:417-678-6233
Mailing Address - Street 1:112 S MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:MO
Mailing Address - Zip Code:65605-1427
Mailing Address - Country:US
Mailing Address - Phone:417-678-6233
Mailing Address - Fax:417-678-6232
Practice Address - Street 1:112 S MADISON AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:MO
Practice Address - Zip Code:65605-1427
Practice Address - Country:US
Practice Address - Phone:417-678-6233
Practice Address - Fax:417-678-6232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty