| Organization Name: | LIFELINE BEHAVIORAL HEALTHCARE LTD. |
| NPI Number: | 1114319043 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHERYL L ANKROM (PRESIDENT) |
| Mailing Address: | 18700 S Wolf Rd Suite 220 Mokena |
| State: | IL US |
| Postal Code: | 604488456 |
| Phone Number: | 7089285700 |
| Fax Number: | 7085701617 |
| NPI Enumeration Date: | 03/02/2015 |
| NPI Last Update Date: | 03/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 180007337 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |