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RWI98122 Lifelong AIDS Alliance (Terminated)
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Main Details
Name
Lifelong AIDS Alliance
Subdivision Name
Type
Ryan White Part A
340B ID
RWI98122
Grant Number
H89HA00022
Additional Details
Current Program Status
Terminated
Registration Date
7/13/2018
Participating Start Date
10/1/2018
Participating Approval Date
8/2/2018
Last Recertification Date
2/13/2020
Time Period the Assistance was Received
Termination Date
Termination Reason
4/1/2021
Failure to recertify
Contacts
Authorizing Official
Lifelong
Claire Neal, CEO
(206) 957-1615
Primary Contact
Lifelong AIDS Alliance
Mark Baker, Deputy Executive Director
(206) 957-1694
Addresses
Street Address
210 S Lucile Street
Seattle, WA 98108
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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Participating from effective date (10/1/2014), until terminated effective date (4/1/2018), reinstatement date effective (10/01/2018)
08/02/2018
April 2025
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