| Lifeline Home Health Inc | |
|
4309 Kenwood Dr Woodbridge VA 22193 | |
| (301) 442-5796 | |
| Not Available |
| Full Name | Lifeline Home Health Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4309 Kenwood Dr, Woodbridge, Virginia |
| Authorized Official Name and Position | Eugenie Mboutchock Kabiwa (CEO) |
| Authorized Official Contact | 3014425796 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifeline Home Health Inc 4309 Kenwood Dr Woodbridge VA 22193-5282 Ph: (301) 442-5796 | Lifeline Home Health Inc 4309 Kenwood Dr Woodbridge VA 22193 Ph: (301) 442-5796 |
| NPI Number | 1972981090 |
|---|---|
| Provider Enumeration Date | 05/08/2015 |
| Last Update Date | 05/08/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972981090 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2407 (Virginia) | Primary |
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