Lifeline Home Health Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

2407 Issued in VA

Legal business name

LIFELINE HOME HEALTH INC

Practice address

4309 Kenwood Dr
Woodbridge, VA 22193

Phone

(301) 442-5796

NPI assigned

May 8, 2015

Last updated

May 8, 2015By 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. Eugenie Mboutchock Kabiwa

Title

Ceo

Phone

(301) 442-5796

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431043200000",
    "number": "1972981090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 KENWOOD DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221935282",
            "telephone_number": "301-442-5796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 KENWOOD DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22193",
            "telephone_number": "301-442-5796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-08",
        "last_updated": "2015-05-08",
        "status": "A",
        "authorized_official_last_name": "KABIWA",
        "authorized_official_first_name": "EUGENIE",
        "authorized_official_middle_name": "MBOUTCHOCK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-442-5796",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "2407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; 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.