Organization
LIFELINE HOME HEALTH CARE OF FULTON, LLC
Active
Other names
Lifeline Health Care of Fulton
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS GACHASSIN III (EXECUTIVE VICE PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
309 MAIN ST, FULTON, KY 42041-1603
(270) 472-2294
(270) 472-2312
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100060850
—
KY
Enumeration date
04/12/2007
Last updated
08/04/2020
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