Provider Demographics
NPI:1447466685
Name:LIFESPRING CENTER
Entity type:Organization
Organization Name:LIFESPRING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:REINICKE
Authorized Official - Suffix:
Authorized Official - Credentials:MARRIAGE & FAMILY TH
Authorized Official - Phone:619-298-8722
Mailing Address - Street 1:2333 CAMINO DEL RIO S
Mailing Address - Street 2:#250
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3607
Mailing Address - Country:US
Mailing Address - Phone:619-298-8722
Mailing Address - Fax:
Practice Address - Street 1:2333 CAMINO DEL RIO S
Practice Address - Street 2:#250
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3607
Practice Address - Country:US
Practice Address - Phone:619-298-8722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty