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:
Health care specialties
Specialty | Code | License # | 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 15 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1144499195 | NPPES |
Michigan | MEDICAID | 1719945 |
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