| Lifeline Connections Health Homes | |
|
1601 E Fourth Plain Blvd Bldg 17 Suite A212 Vancouver WA 98661 | |
| (360) 397-8246 | |
| (360) 397-8250 |
| Full Name | Lifeline Connections Health Homes |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1601 E Fourth Plain Blvd Bldg 17, Vancouver, 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 Health Homes Po Box 1678 Vancouver WA 98668-1678 Ph: (360) 397-8246 | Lifeline Connections Health Homes 1601 E Fourth Plain Blvd Bldg 17 Suite A212 Vancouver WA 98661 Ph: (360) 397-8246 |
| NPI Number | 1396257101 |
|---|---|
| Provider Enumeration Date | 11/02/2017 |
| Last Update Date | 03/01/2023 |
| Certification Date | 03/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396257101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | CO.60429455 (Washington) | Primary |
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