Provider Demographics
NPI:1588390694
Name:LIFEPATH, LLC
Entity type:Organization
Organization Name:LIFEPATH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAHN
Authorized Official - Middle Name:SAMANTHA
Authorized Official - Last Name:CHUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-614-9848
Mailing Address - Street 1:11680 GREAT OAKS WAY STE 130
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-2458
Mailing Address - Country:US
Mailing Address - Phone:678-614-9848
Mailing Address - Fax:770-451-7995
Practice Address - Street 1:11680 GREAT OAKS WAY STE 130
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-2458
Practice Address - Country:US
Practice Address - Phone:678-614-9848
Practice Address - Fax:770-451-7995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service