Longevity Center Llc

LBN: Longevity Center Llc
Longevity Center Llc is an health care organization with primary practice located at 2251 E Paris Ave Se , Grand Rapids MI 49546-2431. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Longevity Center Llc can be contacted via phone (616) 956-6090, or through Allen, Cheryl Lynn via phone (616) 897-2142.

Contact Information

Primary practice address
2251 E Paris Ave Se Grand Rapids MI 49546-2431
Phone: (616) 956-6090
Fax: (616) 956-6099
Website:
Map and Directions
Authorized official contact:
Name: Allen, Cheryl Lynn
Phone: (616) 897-2142

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5101007920 Michigan

Profile Details

NPI number 1144499195
LBN Legal business name Longevity Center Llc
DBA Doing business as
Authorized official Allen, Cheryl Lynn
Entity Organization
Organization subpart 1 No
Enumeration date Feb 25th, 2008
Last updated May 14th, 2009 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144499195 NPPES
Michigan MEDICAID 1719945

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