NPIMap

Organization Active NPI

Health Economic Lifesource Program Services, Inc.

  • Non-emergency Medical Transport (VAN)
  • Crescent City, CA
National Provider Identifier
1982811022
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Legal business name
HEALTH ECONOMIC LIFESOURCE PROGRAM SERVICES, INC.
Practice address
105 Colonial CT
Crescent City, CA 95531-8320
Phone
(707) 465-4357
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mario Paradiso
Title
C.E.O.
Phone
(707) 465-4357

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X Primary

Addresses

Primary practice location

105 Colonial CT
Crescent City, CA 95531-8320

Mailing address

105 Colonial CT
Crescent City, CA 95531
Phone (707) 465-4357

Other identifiers 1

IdentifierTypeStateIssuer
MTN01030FOtherCAMEDI CAL PROVIDER NUMBER

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982811022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 COLONIAL CT",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "95531",
            "telephone_number": "707-465-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 COLONIAL CT",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318320",
            "telephone_number": "707-465-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH ECONOMIC LIFESOURCE PROGRAM SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARADISO",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "707-465-4357"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL PROVIDER NUMBER",
            "identifier": "MTN01030F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crescent City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.