Provider Demographics
NPI:1346477726
Name:HEALTHSPAN INC
Entity Type:Organization
Organization Name:HEALTHSPAN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:L
Authorized Official - Last Name:PAPROCKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-541-4700
Mailing Address - Street 1:5520 W FOREST HOME AVE
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220-1415
Mailing Address - Country:US
Mailing Address - Phone:414-541-4700
Mailing Address - Fax:414-541-4730
Practice Address - Street 1:5520 W FOREST HOME AVE
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-1415
Practice Address - Country:US
Practice Address - Phone:414-541-4700
Practice Address - Fax:414-541-4730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care