Provider Demographics
NPI:1497090187
Name:LIFT TO BETTER HEALTH, LLC
Entity Type:Organization
Organization Name:LIFT TO BETTER HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:TREADWELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:770-366-5177
Mailing Address - Street 1:4319 COVINGTON HWY
Mailing Address - Street 2:STE: 310
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-1214
Mailing Address - Country:US
Mailing Address - Phone:404-289-0142
Mailing Address - Fax:404-289-0144
Practice Address - Street 1:4319 COVINGTON HWY
Practice Address - Street 2:STE: 310
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-1214
Practice Address - Country:US
Practice Address - Phone:404-289-1042
Practice Address - Fax:404-289-0144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-06
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA232207343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)