Organization Name: | LIFELINE THERAPY, LLC |
NPI Number: | 1154318509 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRIS J BREHM (PRESIDENT/CEO) |
Mailing Address: | 4000 Waterdam Plaza Drive Suite 260 Mcmurray |
State: | PA US |
Postal Code: | 15317 |
Phone Number: | 7249415340 |
Fax Number: | 7249415341 |
NPI Enumeration Date: | 09/30/2005 |
NPI Last Update Date: | 02/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0401X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Taxonomy Definition: |