Provider Demographics
NPI:1013113018
Name:MT LEMMON RESCUE RECOVERY LLC
Entity type:Organization
Organization Name:MT LEMMON RESCUE RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-576-1201
Mailing Address - Street 1:PO BOX 759
Mailing Address - Street 2:
Mailing Address - City:MOUNT LEMMON
Mailing Address - State:AZ
Mailing Address - Zip Code:85619-0759
Mailing Address - Country:US
Mailing Address - Phone:520-576-1201
Mailing Address - Fax:520-576-3095
Practice Address - Street 1:13170 N ORACLE CONTROL RD
Practice Address - Street 2:
Practice Address - City:MOUNT LEMMON
Practice Address - State:AZ
Practice Address - Zip Code:85619
Practice Address - Country:US
Practice Address - Phone:520-576-1201
Practice Address - Fax:520-576-3095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Multi-Specialty