Provider Demographics
NPI:1831707678
Name:LIFESPAN HEALTH ASSOCIATES
Entity type:Organization
Organization Name:LIFESPAN HEALTH ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARION
Authorized Official - Middle Name:
Authorized Official - Last Name:AROM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-556-4610
Mailing Address - Street 1:9171 WILSHIRE BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5517
Mailing Address - Country:US
Mailing Address - Phone:310-556-4610
Mailing Address - Fax:310-859-9127
Practice Address - Street 1:9171 WILSHIRE BLVD STE 600
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5517
Practice Address - Country:US
Practice Address - Phone:310-556-4610
Practice Address - Fax:310-859-9127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty