Provider Demographics
NPI:1023561461
Name:LIFELINE HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:LIFELINE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANI
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSEFZAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-338-0382
Mailing Address - Street 1:5487 DON MANRICO CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-3123
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5487 DON MANRICO CT
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-3123
Practice Address - Country:US
Practice Address - Phone:847-338-0382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health