Provider Demographics
NPI:1952940272
Name:LIFEGATE HEALTH SERVICES
Entity Type:Organization
Organization Name:LIFEGATE HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:EMADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-432-7204
Mailing Address - Street 1:1629 K ST NW STE 300
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-1631
Mailing Address - Country:US
Mailing Address - Phone:240-432-7204
Mailing Address - Fax:301-560-6648
Practice Address - Street 1:1629 K ST NW STE 300
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1631
Practice Address - Country:US
Practice Address - Phone:240-432-7204
Practice Address - Fax:301-560-6648
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFEGATE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility