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General NPI Number Information
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NPI Number | 1437346434
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Entity Type | Organization
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Legal Business Name | LIFENET, LLC
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Dates
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Enumeration Date | 10/03/2007
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Last Update Date | 09/03/2008
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Provider Practice Location Address
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Address Line | 800 WISCONSIN ST STE 305
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City | EAU CLAIRE
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State | WI
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Zip | 54703-3588
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Country | US
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Telephone | 715-835-4111
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Fax | 715-835-4359
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Provider Business Mailing Address
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Address Line | PO BOX 1081
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City | EAU CLAIRE
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State | WI
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Zip | 54702
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Country | US
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Telephone | 715-835-4111
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Fax | 715-835-4359
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JEFFREY GEORGE FRESLIN
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Credential |
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Telephone | 715-835-4111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 335
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License Number State | WI
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