Provider Demographics
NPI:1124694484
Name:LIFESAVING ACADEMY
Entity type:Organization
Organization Name:LIFESAVING ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-303-2224
Mailing Address - Street 1:4237 N 62ND ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-1236
Mailing Address - Country:US
Mailing Address - Phone:414-303-2224
Mailing Address - Fax:
Practice Address - Street 1:405 N CALHOUN RD STE 103
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-5902
Practice Address - Country:US
Practice Address - Phone:262-439-8072
Practice Address - Fax:262-439-8072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care