Provider Demographics
NPI:1558996777
Name:LIFE HOUSE OF HOPE
Entity Type:Organization
Organization Name:LIFE HOUSE OF HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:UTING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-843-5972
Mailing Address - Street 1:868 KOEBEL AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-3157
Mailing Address - Country:US
Mailing Address - Phone:614-843-5972
Mailing Address - Fax:
Practice Address - Street 1:868 KOEBEL AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-3157
Practice Address - Country:US
Practice Address - Phone:614-843-5972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty