Provider Demographics
NPI:1073842951
Name:LIFELINE CENTERS, PC
Entity Type:Organization
Organization Name:LIFELINE CENTERS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:KEGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-351-6545
Mailing Address - Street 1:1525 PARK MANOR BLVD STE 308
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-4805
Mailing Address - Country:US
Mailing Address - Phone:412-351-6545
Mailing Address - Fax:412-351-6547
Practice Address - Street 1:84 WELLNESS WAY
Practice Address - Street 2:BLDG 3
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-9720
Practice Address - Country:US
Practice Address - Phone:412-351-6545
Practice Address - Fax:412-273-1958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-23
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty