Organization
HEALTH ECONOMIC LIFESOURCE PROGRAM SERVICES, INC.
Active
Organization
HEALTH ECONOMIC LIFESOURCE PROGRAM SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO PARADISO (C.E.O.)
(707) 465-4357
Entity
Organization
Contact information
Practice address
105 COLONIAL CT, CRESCENT CITY, CA 95531-8320
(707) 465-4357
Mailing address
105 COLONIAL CT, CRESCENT CITY, CA 95531
(707) 465-4357
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MTN01030F
MEDI CAL PROVIDER NUMBER
CA
Enumeration date
05/17/2007
Last updated
08/22/2020
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