Provider Demographics
NPI:1750690202
Name:LIFELINKS COMMUNITY SCHOOL
Entity type:Organization
Organization Name:LIFELINKS COMMUNITY SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:NELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-623-5380
Mailing Address - Street 1:205 W CRAWFORD ST
Mailing Address - Street 2:
Mailing Address - City:VAN WERT
Mailing Address - State:OH
Mailing Address - Zip Code:45891-1903
Mailing Address - Country:US
Mailing Address - Phone:419-623-5380
Mailing Address - Fax:419-238-3974
Practice Address - Street 1:605 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:VAN WERT
Practice Address - State:OH
Practice Address - Zip Code:45891-1302
Practice Address - Country:US
Practice Address - Phone:419-623-5380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health