NPIMap

Organization Active NPI

Native American Lifelines, Inc.

  • Dental Clinic/Center
  • Baltimore, MD
National Provider Identifier
1679863344
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
9848 Issued in MD
Legal business name
NATIVE AMERICAN LIFELINES, INC.
Practice address
106 Clay St
Baltimore, MD 21201-3501
Phone
(410) 837-2258
Fax
(410) 837-2692
NPI assigned
Apr 14, 2011
Last updated
Aug 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Susan Roth
Title
Executive Director
Phone
(410) 837-2258

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 9848 MD Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 904244 MD

Addresses

Primary practice location

106 Clay St
Baltimore, MD 21201-3501

Mailing address

106 Clay St
Baltimore, MD 21201-3501
Phone (410) 837-2258

Other names 1

  • LifeLines Foundation, Inc. Former legal business name

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313452800000",
    "number": "1679863344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 CLAY ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212013501",
            "telephone_number": "410-837-2258",
            "fax_number": "410-837-2692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 CLAY ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212013501",
            "telephone_number": "410-837-2258",
            "fax_number": "410-837-2692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIVE AMERICAN LIFELINES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-14",
        "last_updated": "2011-08-16",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "410-837-2258",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MD",
            "license": "9848",
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MD",
            "license": "904244",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeLines Foundation, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.