Provider Demographics
NPI:1639830458
Name:LIFFEY HEALTH
Entity Type:Organization
Organization Name:LIFFEY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:PATRICK SINGH
Authorized Official - Last Name:DYAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:669-201-4949
Mailing Address - Street 1:1171 HOMESTEAD RD STE 295
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-5486
Mailing Address - Country:US
Mailing Address - Phone:669-201-4949
Mailing Address - Fax:
Practice Address - Street 1:1171 HOMESTEAD RD STE 295
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-5486
Practice Address - Country:US
Practice Address - Phone:510-468-0732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-04
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty