Provider Demographics
NPI: | 1700105327 |
---|---|
Name: | LIFE-TIMESOLUTIONS, LLC |
Entity Type: | Organization |
Organization Name: | LIFE-TIMESOLUTIONS, LLC |
Other - Org Name: | HOPEWELL |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | BLAKE |
Authorized Official - Middle Name: | STEVEN |
Authorized Official - Last Name: | HAYWARD |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | JD |
Authorized Official - Phone: | 850-386-5552 |
Mailing Address - Street 1: | 2121 KILLARNEY WAY STE H |
Mailing Address - Street 2: | |
Mailing Address - City: | TALLAHASSEE |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32309-3400 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 850-386-5552 |
Mailing Address - Fax: | 850-386-5505 |
Practice Address - Street 1: | 2121 KILLARNEY WAY STE H |
Practice Address - Street 2: | |
Practice Address - City: | TALLAHASSEE |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32309-3400 |
Practice Address - Country: | US |
Practice Address - Phone: | 850-386-5552 |
Practice Address - Fax: | 850-386-5505 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-05-21 |
Last Update Date: | 2010-05-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | 30211090 | 251E00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health |