Provider Demographics
NPI:1922617018
Name:L HEUSS LLC
Entity Type:Organization
Organization Name:L HEUSS LLC
Other - Org Name:LIFEVOLV
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HEUSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-349-4677
Mailing Address - Street 1:7231 W BRENTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-6125
Mailing Address - Country:US
Mailing Address - Phone:414-349-4677
Mailing Address - Fax:
Practice Address - Street 1:7231 W BRENTWOOD AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-6125
Practice Address - Country:US
Practice Address - Phone:414-252-9749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-24
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management