MEDICARE: LIFESAVERS SUPPORT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	177F00000X	Lodging Provider
2	251B00000X	Case Management Agency
3	251C00000X	Developmentally Disabled Services Day Training Agency
4	251J00000X	Nursing Care Agency
5	251T00000X	PACE Provider Organization
6	311ZA0620X	Adult Care Home Facility
7	315D00000X	Inpatient Hospice
8	315P00000X	Intellectual Disabilities Intermediate Care Facility
9	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
10	320700000X	Physical Disabilities Residential Treatment Facility
11	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
12	385HR2050X	Respite Care Camp
13	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1174328413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFESAVERS SUPPORT

Provider Business Mailing Address
First Line	:	31132 N PARK DR
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48331-1450
Country	:	US
Telephone Number	:	313-779-5701
Fax Number	:

Provider Business Practice Location Address
First Line	:	16631 SALEM ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48219-3697
Country	:	US
Telephone Number	:	248-600-6484
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. ERICA WOODS
Credential	:
Telephone Number	:	313-779-5701

Provider Enumeration Date	:	02/19/2025
Last Update Date	:	04/20/2026

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Directions to “LIFESAVERS SUPPORT ” Practice Location

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