Provider Demographics
NPI:1215633854
Name:LIFELINE THERAPY UPPER SAINT CLAIR LLC
Entity type:Organization
Organization Name:LIFELINE THERAPY UPPER SAINT CLAIR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BREHM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-576-4338
Mailing Address - Street 1:3824 NORTHERN PIKE STE 660
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2141
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:155 MCMURRAY RD
Practice Address - Street 2:
Practice Address - City:UPPER SAINT CLAIR
Practice Address - State:PA
Practice Address - Zip Code:15241-1654
Practice Address - Country:US
Practice Address - Phone:412-871-3890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty