| Lifeline Connections | |
|
311 S I St Aberdeen WA 98520-6615 | |
| (360) 787-9319 | |
| Not Available |
| Full Name | Lifeline Connections |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 311 S I St, Aberdeen, Washington |
| Authorized Official Name and Position | Kinh Reynolds (CFO) |
| Authorized Official Contact | 3603978246 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifeline Connections Po Box 1678 Vancouver WA 98668-1678 Ph: (360) 397-8246 | Lifeline Connections 311 S I St Aberdeen WA 98520-6615 Ph: (360) 787-9319 |
| NPI Number | 1639719743 |
|---|---|
| Provider Enumeration Date | 01/07/2020 |
| Last Update Date | 03/01/2023 |
| Certification Date | 03/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639719743 | NPI | - | NPPES |
| 1990126 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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