Lifeboat14Llc

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

3MMX839 Issued in CA

Legal business name

LIFEBOAT14LLC

Practice address

218 Estates Dr
Roseville, CA 95678-2312

Phone

(916) 521-8665

NPI assigned

Aug 9, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Petrus Hendrik Van Niekerk

Title

Owner

Phone

(916) 521-8665

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281312000000",
    "number": "1083929574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 PRIVETT CT",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957476440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 ESTATES DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956782312",
            "telephone_number": "916-521-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBOAT14LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-09",
        "last_updated": "2010-08-09",
        "status": "A",
        "authorized_official_last_name": "VAN NIEKERK",
        "authorized_official_first_name": "PETRUS",
        "authorized_official_middle_name": "HENDRIK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-521-8665",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "CA",
            "license": "3MMX839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ziqian Li, MS, RDN, CDCES, CNSC
• Leanne M Liddicoat, O.D.
• Lien Lac LMFT
• Rebecca Lierly, M.A.
• Life Source, Inc.
• Lifespark Health and Wellness Nursing PC
• Lifestyle Nutrition & Dietetics
• Light Within Counseling Inc.
• Don C Light, CADC II
• Joy Light, LMFT

• Non-emergency Medical Transport (VAN) in Roseville, CA
• Providers in Roseville, CA by specialty
• Non-emergency Medical Transport (VAN) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.