Provider Demographics
NPI:1992336697
Name:BREATHALIFE LLC
Entity type:Organization
Organization Name:BREATHALIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUSTAPHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOTAIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-999-8889
Mailing Address - Street 1:8300 VALLEY CIRCLE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91304-3023
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8300 VALLEY CIRCLE BLVD STE B
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91304-3023
Practice Address - Country:US
Practice Address - Phone:313-999-8889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-31
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No122300000XDental ProvidersDentistGroup - Multi-Specialty