Provider Demographics
NPI:1295349868
Name:LIFEPATH HEALTHCARE CORP
Entity type:Organization
Organization Name:LIFEPATH HEALTHCARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:WILMA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARNASO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-589-6240
Mailing Address - Street 1:3000 ALAMO DR STE 209
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-6352
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3000 ALAMO DR STE 209
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-6352
Practice Address - Country:US
Practice Address - Phone:707-679-0128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based