Provider Demographics
NPI:1942977210
Name:REBUILDING LIFE AND EMBRACING DEATH LLC
Entity Type:Organization
Organization Name:REBUILDING LIFE AND EMBRACING DEATH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LASHONDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMSW, CDP, CAGC
Authorized Official - Phone:870-592-0687
Mailing Address - Street 1:PO BOX 298
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:TX
Mailing Address - Zip Code:75457-0298
Mailing Address - Country:US
Mailing Address - Phone:870-592-0687
Mailing Address - Fax:
Practice Address - Street 1:927 N GREER BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:TX
Practice Address - Zip Code:75686-1181
Practice Address - Country:US
Practice Address - Phone:870-592-0687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No342000000XTransportation ServicesTransportation Network Company
No344600000XTransportation ServicesTaxi
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker