NPIMap

Organization Active NPI

The Life Center Complex, Inc

  • Student Health Clinic/Center
  • New Castle, DE
National Provider Identifier
1043798366
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
THE LIFE CENTER COMPLEX, INC
Practice address
16 Pleasant PL
New Castle, DE 19720-3005
Phone
(302) 429-4083
Fax
(302) 429-4078
NPI assigned
Jul 30, 2018
Organization subpart
Yes
Parent organization
THE LIFE CENTER COMPLEX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Authorized official

Name
Forrest Watson, MBA
Title
Ceo
Phone
(302) 552-3574

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X DE Primary
Student Health Clinic/Center 261QS1000X

Addresses

Primary practice location

16 Pleasant PL
New Castle, DE 19720-3005

Mailing address

812 Philadelphia Pike Ste F
Wilmington, DE 19809-2371
Phone (302) 407-5316

National Provider Directory

National Provider Directory
Tax ID family
The Life Center Complex Inc32 organizations share this tax ID, including this one
Part of
The Life Center Complex Inc

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

Locations

812 Philadelphia Pike
Ste F
Wilmington, DE 19809

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1043798366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 PHILADELPHIA PIKE STE F",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198092371",
            "telephone_number": "302-407-5316",
            "fax_number": "302-407-5307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 PLEASANT PL",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197203005",
            "telephone_number": "302-429-4083",
            "fax_number": "302-429-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE LIFE CENTER COMPLEX, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE LIFE CENTER COMPLEX, INC.",
        "enumeration_date": "2018-07-30",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "FORREST",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "302-552-3574",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "DE",
            "license": null,
            "primary": true
        },
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Castle, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.