Provider Demographics
NPI:1851112866
Name:YOUR LIFE AMB ,LLC
Entity type:Organization
Organization Name:YOUR LIFE AMB ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUILVETH
Authorized Official - Middle Name:Y
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-909-2564
Mailing Address - Street 1:PO BOX 1213
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-1213
Mailing Address - Country:US
Mailing Address - Phone:787-909-2564
Mailing Address - Fax:
Practice Address - Street 1:EXT. EL COMANDANTE
Practice Address - Street 2:CALLE VIOLETA #35
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982
Practice Address - Country:US
Practice Address - Phone:787-909-2564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YOUR LIFE AMB,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-22
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport