Lifeline Therapy Grove City LLC

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

LIFELINE THERAPY GROVE CITY LLC

Practice address

225 Westside Square Dr Ste 115
Mercer, PA 16137-4007

Phone

(412) 871-3890

NPI assigned

Jan 4, 2023

Last updated

Jan 4, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Penny Goldberg

Title

Revenue Cycle Manager

Phone

(412) 871-3890

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699488700. Details of each certification follow.

• CCN 394577 Comprehensive outpatient rehabilitation facility · Active · Name & address match · Details

Comprehensive outpatient rehabilitation facility certification: CCN 394577

Legal name

LIFELINE THERAPY GROVE CITY LLC

Certification status

Active

Provider type (POS)

Comprehensive outpatient rehabilitation facility

Participating since

Sep 11, 2023

Last certification

Aug 30, 2023

Ownership / control type

Proprietary

Facility address

225 Westside Square Drive Suite 115
Mercer, PA 16137

Locations

Practitioners 1

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.

• Christopher J Brehm, PT

  • Athletic Trainer
  • Pittsburgh, PA
  • NPI 1902856842
  NPD

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672790400000",
    "number": "1699488700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3824 NORTHERN PIKE STE 660",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462141",
            "telephone_number": "412-871-3890",
            "fax_number": "412-646-1675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 WESTSIDE SQUARE DR STE 115",
            "city": "MERCER",
            "state": "PA",
            "postal_code": "161374007",
            "telephone_number": "412-871-3890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE THERAPY GROVE CITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-04",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "PENNY",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "412-871-3890",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://lifeline-therapy.com",
            "affiliation": "N",
            "address_1": "225 Westside Square Dr Ste 115",
            "city": "Mercer",
            "state": "PA",
            "country_code": "US",
            "postal_code": "161374007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Catherine Lynn Lang, MA LPC NCC
• Laurel Eye Clinic
• Cassandra Arka Legal, CRNP
• Mackenzie Leskovac
• Melissa Lewis
• Cassandra Lipinski, ATC
• Edward Lombardo
• Kathleen Ann Love
• Shayla Lynn, LPN
• Rebecca Nicole Macri, PHARM D.

• Comprehensive Outpatient Rehabilitation Facility (CORF) in Mercer, PA
• Providers in Mercer, PA by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.