Provider Demographics
NPI:1902135866
Name:BREATH OF LIFE LLC
Entity Type:Organization
Organization Name:BREATH OF LIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LESPERANCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-319-1391
Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:SILT
Mailing Address - State:CO
Mailing Address - Zip Code:81652-0043
Mailing Address - Country:US
Mailing Address - Phone:970-319-1391
Mailing Address - Fax:970-625-6114
Practice Address - Street 1:2303 BRANDING IRON
Practice Address - Street 2:
Practice Address - City:SILT
Practice Address - State:CO
Practice Address - Zip Code:81652-8833
Practice Address - Country:US
Practice Address - Phone:970-876-1970
Practice Address - Fax:970-876-2185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-23
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies