Organization
LIFELINE TREATMENT SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA ANN BLANKS (C E O)
(661) 254-6630
Entity
Organization
Contact information
Practice address
10429 INTERNATIONAL BLVD, OAKLAND, CA 94603-3221
(510) 777-8448
(510) 777-8452
Mailing address
26460 SUMMIT CIR, SANTA CLARITA, CA 91350-2991
(661) 254-6630
(661) 254-6644
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
0195
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-99
STATE NTP LICENSE
CA
01
—
0196
MEDI-CAL NUMBER
CA
Enumeration date
04/17/2007
Last updated
10/31/2025
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