Provider Demographics
NPI:1114308731
Name:LIFESPAN CARE LLC
Entity Type:Organization
Organization Name:LIFESPAN CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAUBERT
Authorized Official - Suffix:
Authorized Official - Credentials:ANP
Authorized Official - Phone:337-772-9946
Mailing Address - Street 1:1950 DURALDE HWY
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-2131
Mailing Address - Country:US
Mailing Address - Phone:337-772-9946
Mailing Address - Fax:
Practice Address - Street 1:1950 DURALDE HWY
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535-2131
Practice Address - Country:US
Practice Address - Phone:337-772-9946
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily HealthGroup - Single Specialty