Organization
LIFELINE MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA GRIESHEIMER (COO)
(814) 243-0414
Entity
Organization
Contact information
Practice address
2101 JACKSON ST STE 109, ANDERSON, IN 46016-4386
(814) 408-0014
Mailing address
3159 CARPENTERS PARK RD, DAVIDSVILLE, PA 15928-9223
(814) 408-0014
(814) 479-5906
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99999999999
—
OR
Enumeration date
08/15/2022
Last updated
11/06/2024
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