Provider Demographics
NPI:1790980969
Name:LIFELINK HEALTH PROVIDERS, INC.
Entity Type:Organization
Organization Name:LIFELINK HEALTH PROVIDERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND ROMMEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:SISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-387-9650
Mailing Address - Street 1:211 W FOOTHILL BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-3357
Mailing Address - Country:US
Mailing Address - Phone:626-387-9650
Mailing Address - Fax:626-387-9651
Practice Address - Street 1:211 W FOOTHILL BLVD STE A
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-3357
Practice Address - Country:US
Practice Address - Phone:626-387-9650
Practice Address - Fax:626-387-9651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health