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General NPI Number Information
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NPI Number | 1790980969
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Entity Type | Organization
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Legal Business Name | LIFELINK HEALTH PROVIDERS, INC.
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 03/06/2018
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Provider Practice Location Address
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Address Line | 211 W FOOTHILL BLVD STE A
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City | GLENDORA
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State | CA
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Zip | 91741-3357
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Country | US
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Telephone | 626-387-9650
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Fax | 626-387-9651
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Provider Business Mailing Address
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Address Line | 211 W FOOTHILL BLVD STE A
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City | GLENDORA
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State | CA
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Zip | 91741-3357
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Country | US
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Telephone | 626-387-9650
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Fax | 626-387-9651
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAYMOND ROMMEL S SISON
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Credential |
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Telephone | 626-387-9650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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