Provider Demographics
NPI:1710425772
Name:LIFESAVER RESCUE CARE, LLC
Entity Type:Organization
Organization Name:LIFESAVER RESCUE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAQUEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:KNAPPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-283-3273
Mailing Address - Street 1:6600 N MERIDIAN AVE
Mailing Address - Street 2:SUITE 148
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-1427
Mailing Address - Country:US
Mailing Address - Phone:405-283-3273
Mailing Address - Fax:405-265-9722
Practice Address - Street 1:6600 N MERIDIAN AVE
Practice Address - Street 2:SUITE 148
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1427
Practice Address - Country:US
Practice Address - Phone:405-283-3273
Practice Address - Fax:405-265-9722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKCSS0070251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health