Provider Demographics
NPI:1942733878
Name:LIFE ALLIANCE ORGAN RECOVERY AGENCY
Entity Type:Organization
Organization Name:LIFE ALLIANCE ORGAN RECOVERY AGENCY
Other - Org Name:LAORA
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:CLIFTON
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:MCCLENNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-243-3972
Mailing Address - Street 1:1951 N.W. 7TH AVENUE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136
Mailing Address - Country:US
Mailing Address - Phone:800-232-2892
Mailing Address - Fax:
Practice Address - Street 1:1951 NW 7TH AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1104
Practice Address - Country:US
Practice Address - Phone:800-232-2892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-07
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335U00000XSuppliersOrgan Procurement Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherUM EIN NUMBER