Provider Demographics
NPI:1114397940
Name:LIFE THERAPEUTIC SOLUTIONS, INC
Entity Type:Organization
Organization Name:LIFE THERAPEUTIC SOLUTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWAB
Authorized Official - Suffix:
Authorized Official - Credentials:CTRS, ATRIC
Authorized Official - Phone:616-828-5492
Mailing Address - Street 1:PO BOX 90002
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49509-9919
Mailing Address - Country:US
Mailing Address - Phone:616-828-5492
Mailing Address - Fax:855-207-3270
Practice Address - Street 1:561 PARKSIDE AVE NW
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49534-3410
Practice Address - Country:US
Practice Address - Phone:616-828-5492
Practice Address - Fax:855-207-3270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health