Provider Demographics
NPI:1235670191
Name:LICE POLICE INC
Entity type:Organization
Organization Name:LICE POLICE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:MEFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-370-4635
Mailing Address - Street 1:520 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62650-2977
Mailing Address - Country:US
Mailing Address - Phone:217-204-9227
Mailing Address - Fax:
Practice Address - Street 1:520 S MAIN ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62650-2977
Practice Address - Country:US
Practice Address - Phone:217-204-9227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-12
Last Update Date:2017-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty