Provider Demographics
NPI:1982684437
Name:TRUSTED LIFE CARE, INC.
Entity Type:Organization
Organization Name:TRUSTED LIFE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUIDETTI
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:469-499-2857
Mailing Address - Street 1:1425 GREENWAY DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038
Mailing Address - Country:US
Mailing Address - Phone:469-499-2856
Mailing Address - Fax:469-499-2806
Practice Address - Street 1:780 DEDHAM ST
Practice Address - Street 2:SUITE 600
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-1415
Practice Address - Country:US
Practice Address - Phone:781-575-9676
Practice Address - Fax:781-575-0184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-19
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA4175040001Medicare NSC