Provider Demographics
NPI:1558178996
Name:LIFE SAVIOR PALLIATIVE CARE LLC
Entity type:Organization
Organization Name:LIFE SAVIOR PALLIATIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:SELINA
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, AGNP-C
Authorized Official - Phone:843-992-2682
Mailing Address - Street 1:1782 LAKE WATEREE DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-8178
Mailing Address - Country:US
Mailing Address - Phone:843-992-2682
Mailing Address - Fax:
Practice Address - Street 1:1782 LAKE WATEREE DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-8178
Practice Address - Country:US
Practice Address - Phone:843-992-2682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty