Provider Demographics
NPI:1538315320
Name:LIFE LINE NURSING CARE, INC.
Entity Type:Organization
Organization Name:LIFE LINE NURSING CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPELL SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-969-4518
Mailing Address - Street 1:16000 SW 100TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-3202
Mailing Address - Country:US
Mailing Address - Phone:305-969-4518
Mailing Address - Fax:305-969-4518
Practice Address - Street 1:16000 SW 100TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-3202
Practice Address - Country:US
Practice Address - Phone:305-969-4518
Practice Address - Fax:305-969-4518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211276251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care