Provider Demographics
NPI:1417256892
Name:HUMANITARIAN EMERGENCY LIFE PROGRAM, INC
Entity Type:Organization
Organization Name:HUMANITARIAN EMERGENCY LIFE PROGRAM, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREMIAH
Authorized Official - Middle Name:AUGUSTINE
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:980-216-9462
Mailing Address - Street 1:3126 MILTON RD STE 235
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-3782
Mailing Address - Country:US
Mailing Address - Phone:704-831-8227
Mailing Address - Fax:
Practice Address - Street 1:3126 MILTON RD STE 235
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-3782
Practice Address - Country:US
Practice Address - Phone:704-831-8227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care