LONGEVITY CENTER LLC - NPI 1144499195 - Family Medicine in Grand Rapids, MI

Q: What is Longevity Center LLC's NPI number?

The NPI number for Longevity Center LLC is 1144499195. It was assigned to this organization in the NPPES registry on February 25, 2008.

Q: What is Longevity Center LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

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About Longevity Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LONGEVITY CENTER LLC (NPI 1144499195) is a healthcare organization registered as a family medicine in Grand Rapids, Michigan and active in the NPI registry since February 2008. The organization lists Cheryl Lynn Allen, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1144499195

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameLONGEVITY CENTER LLC

Location Address2251 E PARIS AVE SEGrand Rapids, MI 49546-2431

Mailing Address2251 E Paris Ave SeGrand Rapids, MI 49546-2431 · (616) 956-6090 · Fax (616) 956-6099

Phone(616) 956-6090

Fax(616) 956-6099

Organization SubpartNo

Authorized OfficialCheryl Lynn AllenBilling Manager · (616) 897-2142

Enumeration DateFebruary 25, 2008

Last NPPES UpdateMay 14, 2009

✔ NPI 1144499195 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MI · 5101007920

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2251 E PARIS AVE SE, Grand Rapids, MI 49546

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Other Identifiers 2

Medicare UPINE26571MI

Medicaid1719945MI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LINDSAY CHAPMAN

Occupational Therapist