=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861267478
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RESCUE LIFE HEALTH CARE SYSTEM LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/24/2023
-----------------------------------------------------
Last Update Date | 11/24/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2776 WASHINGTON DR STE 100
-----------------------------------------------------
City | NORMAN
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73069-1018
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-235-9253
-----------------------------------------------------
Fax | 800-608-9399
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2776 WASHINGTON DR STE 100
-----------------------------------------------------
City | NORMAN
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73069-1018
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-235-9253
-----------------------------------------------------
Fax | 800-608-9399
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | HUNNICUTT S HUNNICUTT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-235-9253
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------