1427388958 NPI number — LIVINGSTON FAMILY CENTER

Table of content: (NPI 1427388958)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427388958 NPI number — LIVINGSTON FAMILY CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LIVINGSTON FAMILY CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427388958
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/06/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4736 E M36
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PINCKNEY
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48169-9383
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-231-9591
Provider Business Mailing Address Fax Number:
810-231-9522

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4736 E M36
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PINCKNEY
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48169-9383
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-231-9591
Provider Business Practice Location Address Fax Number:
810-231-9522
Provider Enumeration Date:
01/06/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LOESCHE
Authorized Official First Name:
JANET
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
810-231-9591

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  6301011048 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 6301013329 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 6401002776 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X , with the licence number: 6801034876 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 104100000X , with the licence number: 6801035150 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X , with the licence number: 6801081106 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X , with the licence number: 6801078115 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X , with the licence number: 6801068018 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X , with the licence number: 6801090913 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)