LONGEVITY CENTER LLC NPI 1144499195

NPI Information

  • NPI: 1144499195
  • Provider Name: LONGEVITY CENTER LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 2251 E PARIS AVE SE
    GRAND RAPIDS, MI
    ZIP 49546
  • Phone: (616) 956-6090

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NPI Details

LONGEVITY CENTER LLC is a family medicine in Grand Rapids, MI. The provider is 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. LONGEVITY CENTER LLC NPI is 1144499195. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2251 E PARIS AVE SE
GRAND RAPIDS, MI
ZIP 49546-431
Phone: (616) 956-6090
Fax: (616) 956-6099

The provider's authorized official is Cheryl Lynn Allen .
The authorized official title is Billing Manager and has the following contact phone number (616) 897-2142.

The enumeration date for this NPI number is 2/25/2008 and was last updated on 5/14/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine5101007920MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1E26571MEDICARE UPINMICHIGAN
21719945MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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