Healthcare Provider Details

I. General information

NPI: 1770579468
Provider Name (Legal Business Name): LIFELINE THERAPY WARRENDALE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 01/04/2023
Certification Date: 01/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 FOWLER RD STE 40
WARRENDALE PA
15086-1132
US

IV. Provider business mailing address

100 FOREST HILLS PLZ
PITTSBURGH PA
15221-5211
US

V. Phone/Fax

Practice location:
  • Phone: 724-933-3280
  • Fax: 724-933-3288
Mailing address:
  • Phone: 412-829-2450
  • Fax: 412-829-2468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251C2600X
TaxonomyCardiopulmonary Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER J BREHM
Title or Position: PRESIDENT/CEO
Credential:
Phone: 412-829-2450