Lifelong Health Center, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

LIFELONG HEALTH CENTER, INC.

Practice address

642 N Main St
Salem, AR 72576-0220

Phone

(870) 895-5433

Fax

(870) 895-5430

NPI assigned

Mar 14, 2006

Last updated

Dec 7, 2007By 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. Laura Elizabeth Estes

Title

Clinic Manager

Phone

(870) 895-5433

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1083683932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "SALEM",
            "state": "AR",
            "postal_code": "725760220",
            "telephone_number": "870-895-5433",
            "fax_number": "870-895-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 N MAIN ST",
            "city": "SALEM",
            "state": "AR",
            "postal_code": "725760220",
            "telephone_number": "870-895-5433",
            "fax_number": "870-895-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELONG HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "ESTES",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "870-895-5433",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155977002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Holly Candace Martin, OTR/L
• Mirenda Martin, APRN
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• Elisabeth Mathews, PHARM. D.
• Venita Lynne Ninemire

• Clinic/Center in Salem, AR
• Providers in Salem, AR by specialty
• Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.