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1346068616 NPI number — LIFELINE TREATMENT CENTER, INC.

NPI Number: 1346068616
Health Care Provider/Practitioner: LIFELINE TREATMENT CENTER, INC.

Information about “1346068616” NPI (LIFELINE TREATMENT CENTER, INC.) exists in 1346068616 in HTML format HTML  |  1346068616 in plain Text format TXT  |  1346068616 in PDF (Portable Document Format) PDF  |  1346068616 in an XML format XML  formats.

NPI Number : 1346068616 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1346068616",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "LIFELINE TREATMENT CENTER, INC.",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6851 CANBY AVE STE 102",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "RESEDA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91335-4307",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "6851 CANBY AVE STE 102",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RESEDA",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "91335-4307",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "323-356-4157",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/26/2024",
    "LastUpdateDate": "12/15/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "LEDVINA",
    "AuthorizedOfficialFirstName": "MARINA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "323-356-4157",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QM0850X",
          "TaxonomyName": "Adult Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QR0405X",
          "TaxonomyName": "Substance Use Disorder Rehabilitation Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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