Provider Demographics
NPI:1760818645
Name:LIFE LINE PILLAR HOMES
Entity Type:Organization
Organization Name:LIFE LINE PILLAR HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BUEHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-629-3331
Mailing Address - Street 1:22331 STRASSBURG AVE
Mailing Address - Street 2:
Mailing Address - City:SAUK VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60411-5722
Mailing Address - Country:US
Mailing Address - Phone:219-629-3331
Mailing Address - Fax:708-843-9073
Practice Address - Street 1:22331 STRASSBURG AVE
Practice Address - Street 2:
Practice Address - City:SAUK VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60411-5722
Practice Address - Country:US
Practice Address - Phone:219-629-3331
Practice Address - Fax:708-843-9073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management