Provider Demographics
NPI:1467902544
Name:LIFESAVERS HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:LIFESAVERS HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:AVETTE
Authorized Official - Last Name:SINCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:DDIV
Authorized Official - Phone:240-580-1510
Mailing Address - Street 1:4600 POWDER MILL RD
Mailing Address - Street 2:SUITE 450 Z13
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-2675
Mailing Address - Country:US
Mailing Address - Phone:240-580-1510
Mailing Address - Fax:240-580-1516
Practice Address - Street 1:4600 POWDER MILL RD
Practice Address - Street 2:SUITE 450 Z13
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-2675
Practice Address - Country:US
Practice Address - Phone:240-580-1510
Practice Address - Fax:240-580-1516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-12
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3957251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health