Organization
LIFE LINE HEALTH SERVICES
Active
Other names
the Vitamin Lounge
Organization subpart
No
Provider details
NPI number
Authorized official
JASMINE BENNETT LVN (CEO)
(707) 510-6625
Entity
Organization
Contact information
Practice address
312 N SCHOOL ST, UKIAH, CA 95482-4312
(707) 510-6625
(707) 868-6062
Mailing address
312 N SCHOOL ST, UKIAH, CA 95482-4312
(707) 510-6625
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
01/14/2025
Last updated
08/22/2025
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