Provider Demographics
NPI:1164871497
Name:LIFELINE INC
Entity Type:Organization
Organization Name:LIFELINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BASSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BASSEY
Authorized Official - Suffix:
Authorized Official - Credentials:HUMAN RESOURCES
Authorized Official - Phone:202-588-8036
Mailing Address - Street 1:2833 GEORGIA AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3862
Mailing Address - Country:US
Mailing Address - Phone:202-588-8036
Mailing Address - Fax:
Practice Address - Street 1:2833 GEORGIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3862
Practice Address - Country:US
Practice Address - Phone:202-588-8036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12034251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health