Provider Demographics
NPI:1750712006
Name:LIFELINE MANAGEMENT, INC.
Entity type:Organization
Organization Name:LIFELINE MANAGEMENT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OLUBUKOLA
Authorized Official - Middle Name:A
Authorized Official - Last Name:OLUSANYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-589-5289
Mailing Address - Street 1:9800 CENTRE PKWY
Mailing Address - Street 2:SUITE 655
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8271
Mailing Address - Country:US
Mailing Address - Phone:713-589-5289
Mailing Address - Fax:713-995-1806
Practice Address - Street 1:9800 CENTRE PKWY
Practice Address - Street 2:SUITE 655
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8271
Practice Address - Country:US
Practice Address - Phone:713-589-5289
Practice Address - Fax:713-995-1806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011283251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health