Provider Demographics
NPI:1255006961
Name:LIFESPRING INC.
Entity Type:Organization
Organization Name:LIFESPRING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP COMMUNITY HEALTH INITIATIVES
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:DRPH
Authorized Official - Phone:812-206-1362
Mailing Address - Street 1:460 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3452
Mailing Address - Country:US
Mailing Address - Phone:812-280-2080
Mailing Address - Fax:
Practice Address - Street 1:1101 N SHELBY ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:IN
Practice Address - Zip Code:47167-1678
Practice Address - Country:US
Practice Address - Phone:812-280-2080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFESPRING INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-13
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)