Provider Demographics
NPI:1922145457
Name:ADVANCED LIFELINE SERVICES INC
Entity Type:Organization
Organization Name:ADVANCED LIFELINE SERVICES INC
Other - Org Name:ALS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-426-1958
Mailing Address - Street 1:200 WHITTINGTON PKWY
Mailing Address - Street 2:STE 207
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222
Mailing Address - Country:US
Mailing Address - Phone:502-426-1958
Mailing Address - Fax:502-426-2337
Practice Address - Street 1:1919 112 STREET SW
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204
Practice Address - Country:US
Practice Address - Phone:425-347-8737
Practice Address - Fax:425-347-8972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9058710Medicaid