Provider Demographics
NPI:1154120327
Name:CONNECTED IV LIFE
Entity type:Organization
Organization Name:CONNECTED IV LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:RINKER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, LCSW-C, LCSW
Authorized Official - Phone:202-491-8385
Mailing Address - Street 1:650 STRETFORD WAY APT 103
Mailing Address - Street 2:
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-5951
Mailing Address - Country:US
Mailing Address - Phone:202-491-8385
Mailing Address - Fax:
Practice Address - Street 1:650 STRETFORD WAY APT 103
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-5951
Practice Address - Country:US
Practice Address - Phone:202-491-8385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center