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Organization
LIFESAVER INTERVENTION CENTER INC
Active
Organization
LIFESAVER INTERVENTION CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDY HANSON DNP, APRN, FNP-BC (CEO)
(877) 989-9198
Entity
Organization
Contact information
Practice address
7933 S YATES BLVD STE 205, CHICAGO, IL 60617-1102
(877) 989-9198
Mailing address
7933 S YATES BLVD STE 205, CHICAGO, IL 60617-1102
(877) 989-9198
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QM2800X
Methadone Clinic
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
09/06/2022
Last updated
09/06/2022
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