LIFELINE TREATMENT SERVICES INC (NPI# 1689890758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689890758 |
Entity Type | Organization |
Organization Name | LIFELINE TREATMENT SERVICES INC |
Practice Address |
10429 International Blvd Oakland CA 94603-3221 |
Mailing Address |
26460 Summit Cir Santa Clarita CA 91350-2991 |
Practice Telephone | 5107778448 |
Practice Fax Number | 5107778452 |
Mailing Telephone | 6612546630 |
Mailing Fax Number | 6612546644 |
Enumeration Date | 2007-04-17 |
Last Update Date | 2020-01-08 |
Authorized Official Name | MR. PRAMESH PRAKASH SHARMA (SR VP) |
Authorized Official Telephone | 6612546630 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
0195 | CA | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | STATE NTP LICENSE | 01-99 | 01 |
CA | MEDI-CAL NUMBER | 0196 | 01 |
Street Address |
10429 INTERNATIONAL BLVD |
City | OAKLAND |
State | CA |
Zip Code | 94603-3221 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760007751 | Darcey Erin Elizabeth Clark | Counselor | 10429 International Blvd, Oakland, CA 94603-3221 | 2020-06-15 |
1205487105 | Delicia Ann Torres | Licensed Vocational Nurse | 10429 International Blvd, Oakland, CA 94603-3221 | 2019-09-23 |
1427513233 | Kristina Marie Grisso | Counselor | 10429 International Blvd, Oakland, CA 94603-3221 | 2019-02-06 |
1891250957 | Angela Sophia Alba Nunes | Licensed Vocational Nurse | 10429 International Blvd, Oakland, CA 94603-3221 | 2019-02-04 |
1770047730 | Jennifer Rosa Ortiz | Licensed Vocational Nurse | 10429 International Blvd, Oakland, CA 94603-3221 | 2019-01-24 |
1225509359 | Teerikca Renee Houston | Licensed Vocational Nurse | 10429 International Blvd, Oakland, CA 94603-3221 | 2018-12-16 |
1255833042 | Tawny Denisha Williams | Counselor | 10429 International Blvd, Oakland, CA 94603-3221 | 2018-03-07 |
1740792555 | Jenay I Brown | Counselor | 10429 International Blvd, Oakland, CA 94603-3221 | 2017-11-02 |
1285184846 | Sharrise Williams | Counselor | 10429 International Blvd, Oakland, CA 94603 | 2016-10-07 |
1659821213 | Linna Hov | Counselor | 10429 International Blvd, Oakland, CA 94603 | 2016-10-07 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235694092 | Kimberlyn Taylor | Behavioral Analyst | 11042 Robledo Dr, Oakland, CA 94603 | 2019-02-06 |
1114414315 | Christopher Maurice Cain | Community Health Worker | 9925 International Blvd #5, Oakland, CA 94603 | 2018-04-13 |
1720508039 | Jessie James King Jr. | Counselor | 9925 International Blvd Suite #5, 9925 International Blvd Suite #5, Oakland, CA 94603 | 2017-06-27 |
1619426475 | Susana Obispo | Counselor | 10429 International Boulevard, Oakland, CA 94603 | 2016-09-22 |
1760764955 | Paul E Rammer | Marriage & Family Therapist | 1523 Chandler Street, Oakland, CA 94603 | 2011-09-13 |
1447250998 | East Oakland Obs Gyn Med Gp Inc | Obstetrics & Gynecology | 9925 International Blvd, Ste 1, Oakland, CA 94603 | 2005-07-27 |
1508148685 | Kimberly Alston-stepnitz | Counselor | 9925 International Blvd, Oakland, CA 94603 | 2011-09-14 |
1699729426 | Robert Scott Millard | Physical Medicine & Rehabilitation | 500 Arguello Street, Suite 100, Redwood City, CA 94603 | 2006-05-19 |
1982920542 | Alwaha Travel Agency for Hajj and Umrah LLC | Non-emergency Medical Transport (VAN) | 60 98th Ave Ste 100, Oakland, CA 94603-1000 | 2010-04-07 |
1336637644 | Carlos Leonel Lopez | Technician, Other | 301 Clara St, Oakland, CA 94603-1101 | 2018-04-23 |
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Taxonomy Code | 261QM2800X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Methadone Clinic |
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
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1417214727 | Fort Help, LLC | Clinic/Center | 9442 International Blvd, Oakland, CA 94603-1444 | 2012-04-12 |
1922364413 | Lifeline Treatment Services, Inc | Clinic/Center | 9442 International Blvd, Oakland, CA 94603-1444 | 2012-04-09 |
1598060683 | Lifeline Treatment Services | Clinic/Center | 9442 International Blvd, Oakland, CA 94603-1444 | 2011-01-20 |
1093976417 | Baart Behavioral Health Services | Clinic/Center | 1124 International Blvd, Oakland, CA 94606-4331 | 2008-06-18 |
1205035425 | Addiction Research and Treatment, Inc | Clinic/Center | 1124 International Blvd, Oakland, CA 94606-4331 | 2007-07-17 |
1912106139 | Baart Behavioral Health Services, Inc | Clinic/Center | 1124 International Blvd, Oakland, CA 94606-4331 | 2007-07-17 |
1720204696 | Humanistic Alternatives To Addiction Research and Treatment, Inc. | Clinic/Center | 10850 Macarthur Blvd, Oakland, CA 94605-5266 | 2007-04-18 |
1043331630 | The West Oakland Health Council | Clinic/Center | 700 Adeline St, Oakland, CA 94607-2608 | 2007-04-02 |
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1083141600 | Baart Behavioral Health Services, Inc. | Clinic/Center | 1145 Market St Fl 10, San Francisco, CA 94103-1566 | 2017-05-13 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.