Provider Demographics
NPI:1306183710
Name:LIFELONG HEALTH FOR ALL
Entity Type:Organization
Organization Name:LIFELONG HEALTH FOR ALL
Other - Org Name:WASHINGTON CARE COORINDATION SERVICES GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF STRATEGY AND COMPLIANCE OFFIC
Authorized Official - Prefix:
Authorized Official - First Name:MARSHALL
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:206-957-1614
Mailing Address - Street 1:210 S LUCILE ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-2432
Mailing Address - Country:US
Mailing Address - Phone:206-957-1650
Mailing Address - Fax:
Practice Address - Street 1:210 S LUCILE ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-2432
Practice Address - Country:US
Practice Address - Phone:206-957-1650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No174200000XOther Service ProvidersMeals
No332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1659564722Medicaid