Healthcare Provider Details

I. General information

NPI: 1346742749
Provider Name (Legal Business Name): LIFT BUSINESS SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2018
Last Update Date: 03/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3952 PATTERSON RD APT 9
RIVERBANK CA
95367-3050
US

IV. Provider business mailing address

PO BOX 578132
MODESTO CA
95357-8132
US

V. Phone/Fax

Practice location:
  • Phone: 209-818-2128
  • Fax:
Mailing address:
  • Phone: 209-818-2128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: PHEBE SIMMONS
Title or Position: CONTRACTOR
Credential:
Phone: 209-815-8468