Provider Demographics
NPI:1821352972
Name:LIFESPIRE, INC.
Entity Type:Organization
Organization Name:LIFESPIRE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-741-0100
Mailing Address - Street 1:1 WHITEHALL ST FL 9
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-2141
Mailing Address - Country:US
Mailing Address - Phone:212-741-0100
Mailing Address - Fax:646-473-0589
Practice Address - Street 1:315 JAMES STREET
Practice Address - Street 2:
Practice Address - City:CONNELLY
Practice Address - State:NY
Practice Address - Zip Code:12417
Practice Address - Country:US
Practice Address - Phone:845-331-7141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities