Provider Demographics
NPI:1457684011
Name:LIFELINE PHYSICAL THERAPY &REHABILITATION, LLC
Entity Type:Organization
Organization Name:LIFELINE PHYSICAL THERAPY &REHABILITATION, 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:JOHN
Authorized Official - Last Name:BREHM
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:412-829-2450
Mailing Address - Street 1:100 FOREST HILLS PLZ
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-5211
Mailing Address - Country:US
Mailing Address - Phone:412-829-2450
Mailing Address - Fax:412-829-2468
Practice Address - Street 1:655 BRADDOCK AVE
Practice Address - Street 2:
Practice Address - City:EAST PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15112-1258
Practice Address - Country:US
Practice Address - Phone:412-829-2450
Practice Address - Fax:412-829-2468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy