| Organization Name: | CHEBOYGAN LIFE SUPPORT SYSTEMS INC |
| NPI Number: | 1225059587 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DALLAS LEE HYDE (DIRECTOR OF CLSS) |
| Mailing Address: | 536 Riggs Dr Cheboygan |
| State: | MI US |
| Postal Code: | 497211063 |
| Phone Number: | 2316279348 |
| Fax Number: | 2316271658 |
| NPI Enumeration Date: | 07/22/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 161003 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |