| NPI | 1245995513 |
|---|---|
| Former Legal Business Name | LIFESPAN HEALTHCARE, LLC |
| Entity Type | Organization |
| Authorized Contact | HELEN VIBAN Medical Director 240-593-1485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2021-11-02 |