Provider Demographics
NPI:1811389364
Name:LIFENET
Entity Type:Organization
Organization Name:LIFENET
Other - Org Name:LIFENET
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AIYANNA
Authorized Official - Middle Name:E
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-358-5193
Mailing Address - Street 1:809 S. 9TH STREET
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:WY
Mailing Address - Zip Code:82633-2959
Mailing Address - Country:US
Mailing Address - Phone:307-358-5193
Mailing Address - Fax:307-358-3438
Practice Address - Street 1:809 S. 9TH STREET
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:WY
Practice Address - Zip Code:82633-2959
Practice Address - Country:US
Practice Address - Phone:307-358-5193
Practice Address - Fax:307-358-3438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-20
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management