| Lifeline Resources, Llc | |
|
3125 Douglas Ave Ste 100 Des Moines IA 50310-5310 | |
| (515) 256-8001 | |
| (515) 256-8082 |
| Full Name | Lifeline Resources, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3125 Douglas Ave Ste 100, Des Moines, Iowa |
| Authorized Official Name and Position | Vincent A Kelly (OWNER/VICE-PRESIDENT) |
| Authorized Official Contact | 5152568001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifeline Resources, Llc 3125 Douglas Ave Ste 100 Des Moines IA 50310-5310 Ph: (515) 256-8001 | Lifeline Resources, Llc 3125 Douglas Ave Ste 100 Des Moines IA 50310-5310 Ph: (515) 256-8001 |
| NPI Number | 1073664694 |
|---|---|
| Provider Enumeration Date | 01/12/2007 |
| Last Update Date | 07/01/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073664694 | NPI | - | NPPES |
| 0401894 | Medicaid | IA | |
| 0401892 | Medicaid | IA | |
| 600013244 | Other | IA | MAGELLAN |
| 0015180 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 02581 (Iowa) | Primary |
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