Lifesource,inc
NPI #1073954806 in Sweet Home, Oregon
Provider Information
- NPI Number
- 1073954806
- Entity Type
- Organization
- Organization Name
- Lifesource,inc
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Jul 9, 2013
- Last Updated
- Jul 9, 2013
Practice Location
- Address
- 1266 44TH AVE
- City
- Sweet Home
- State
- Oregon
- ZIP Code
- 97386-1235
- Phone
- (541) 409-1206
Authorized Official
- Name
- MR. PETER THOMAS KAUFFMAN, MA
- Title
- PRESIDENT
- Phone
- (541) 409-1206
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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