Life Span Home, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

LIFE SPAN HOME, INC

Practice address

4041 Bridge Street
Fair Oaks, CA 95628

Phone

(916) 965-0110

Fax

(916) 965-0102

NPI assigned

Jan 2, 2015

Organization subpart

No

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

Authorized official

Name

Elizabeth Southorn, MACP

Title

Executive Director

Phone

(916) 965-0110

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1420156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420156800000",
    "number": "1942698790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4041 BRIDGE STREET",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "95628",
            "telephone_number": "916-965-0110",
            "fax_number": "916-965-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4041 BRIDGE STREET",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "95628",
            "telephone_number": "916-965-0110",
            "fax_number": "916-965-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE SPAN HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-02",
        "last_updated": "2015-01-02",
        "status": "A",
        "authorized_official_last_name": "SOUTHORN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "916-965-0110",
        "authorized_official_credential": "MACP"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lets Acupuncture
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• Mirra Lynn Lewis
• Xin-Nong Li, MD
• Life Skills Training and Educational Programs, Inc.
• Lifestar Sacramento
• Natasha Lim
• Melissa Lynn Lipari, DPM
• Richard G Lockmiller, M.D.
• Heather Rene Logan

• Home Health Agency in Fair Oaks, CA
• Providers in Fair Oaks, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2015; 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.