Provider Demographics
NPI:1821596289
Name:LIFE GATE HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:LIFE GATE HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ED
Authorized Official - Prefix:MRS
Authorized Official - First Name:BOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLADUNNI
Authorized Official - Suffix:
Authorized Official - Credentials:ED
Authorized Official - Phone:443-824-0851
Mailing Address - Street 1:90 PAINTERS MILL RD STE 131
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3610
Mailing Address - Country:US
Mailing Address - Phone:443-870-0272
Mailing Address - Fax:443-660-7738
Practice Address - Street 1:90 PAINTERS MILL RD STE 131
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3610
Practice Address - Country:US
Practice Address - Phone:443-824-0851
Practice Address - Fax:443-660-7738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-30
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health