Life Uncommon, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

LIFE UNCOMMON, LLC

Practice address

8616 La Tijera Blvd
Suite 404
Los Angeles, CA 90045-3944

Phone

(310) 356-9951

NPI assigned

Aug 29, 2015

Last updated

Oct 13, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Corrie L Greathouse

Title

Chief Executive Officer

Phone

(310) 356-9951

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444694400000",
    "number": "1033586698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8616 LA TIJERA BLVD",
            "address_2": "SUITE 404",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453944",
            "telephone_number": "310-356-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8616 LA TIJERA BLVD",
            "address_2": "SUITE 404",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453944",
            "telephone_number": "310-356-9951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE UNCOMMON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-29",
        "last_updated": "2015-10-13",
        "status": "A",
        "authorized_official_last_name": "GREATHOUSE",
        "authorized_official_first_name": "CORRIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "310-356-9951",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.