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General NPI Number Information
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NPI Number | 1881003929
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Entity Type | Organization
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Legal Business Name | LIFELINE CENTER
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Dates
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Enumeration Date | 08/02/2014
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Last Update Date | 08/02/2014
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Provider Practice Location Address
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Address Line | 7322 SOUTHWEST FWY STE 1100
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City | HOUSTON
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State | TX
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Zip | 77074-2032
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Country | US
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Telephone | 954-446-5206
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Fax |
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Provider Business Mailing Address
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Address Line | 7322 SOUTHWEST FWY STE 1100
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City | HOUSTON
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State | TX
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Zip | 77074-2032
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL DIRECTOR
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Name | DR. YVES ABRAHAM
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Credential |
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Telephone | 954-446-5206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 202278
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License Number State | TX
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