Provider Demographics
NPI:1427418342
Name:LIFELINE THERAPY MONROEVILLE LLC
Entity Type:Organization
Organization Name:LIFELINE THERAPY MONROEVILLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:BREHM
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS, ATC
Authorized Official - Phone:412-829-2450
Mailing Address - Street 1:1 MONROEVILLE CTR
Mailing Address - Street 2:SUITE 680
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-4048
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 MONROEVILLE CTR
Practice Address - Street 2:SUITE 680
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-4048
Practice Address - Country:US
Practice Address - Phone:412-871-3890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)