Provider Demographics
NPI:1548418957
Name:LIFESAVERS AMBULANCE GROUP, INC.
Entity Type:Organization
Organization Name:LIFESAVERS AMBULANCE GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SYLVESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:ARISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-922-0693
Mailing Address - Street 1:120 S MAIN ST STE 220
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-8144
Mailing Address - Country:US
Mailing Address - Phone:713-922-0693
Mailing Address - Fax:713-975-8245
Practice Address - Street 1:120 S MAIN ST STE 220
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-8144
Practice Address - Country:US
Practice Address - Phone:713-922-0693
Practice Address - Fax:713-975-8245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10001613416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport