Life Treatment Centers

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

806-0-ASR Issued in IN

Legal business name

LIFE TREATMENT CENTERS

Practice address

1402 S Michigan St
South Bend, IN 46613-2214

Phone

(574) 233-5433

Fax

(574) 239-6407

NPI assigned

Jun 16, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. David Nowak, MSBA,MBA,PHR

Title

Ceo

Phone

(574) 233-5433

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shakira Desavoir, LMHC, NCC, MA, MS

  • Mental Health Counselor
  • Indianapolis, IN
  • NPI 1881120798
  NPD (past)
• Audrey Flora, LCSW

  • Clinical Social Worker
  • Mishawaka, IN
  • NPI 1548153513
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308182400000",
    "number": "1437444692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 S MICHIGAN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466132214",
            "telephone_number": "574-233-5433",
            "fax_number": "574-239-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 S MICHIGAN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466132214",
            "telephone_number": "574-233-5433",
            "fax_number": "574-239-6407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE TREATMENT CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-16",
        "last_updated": "2011-06-16",
        "status": "A",
        "authorized_official_last_name": "NOWAK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "574-233-5433",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSBA,MBA,PHR"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "IN",
            "license": "806-0-ASR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Liepert, MD
• Susan Jane Lies, MSN, RN
• Life Access Group LLC
• Life in Balance, LLC
• Life Solutions Inc (Stephanie Sarell)
• Lifesource of North Carolina
• Lifetime Dental Careof Indiana, PC (South Bend Family Dental Care)
• Tera Lighthall
• Teri Lighthall
• Maia Ligocki, RBT

• Substance Abuse Rehabilitation Facility in South Bend, IN
• Providers in South Bend, IN by specialty
• Substance Abuse Rehabilitation Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.