NPIMap

Organization Active NPI

The Life Center Complex, Inc.

Doing business as Life Health at Wilbur

  • Student Health Clinic/Center
  • Bear, DE
National Provider Identifier
1174004345
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
THE LIFE CENTER COMPLEX, INC.
Doing business as
Life Health at Wilbur
The Life Health Center
Practice address
4050 Wrangle Hill Rd
Bear, DE 19701
Phone
(302) 552-3574
Fax
(302) 552-3561
NPI assigned
Aug 27, 2018
Last updated
Aug 27, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
THE LIFE CENTER COMPLEX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

4050 Wrangle Hill Rd
Bear, DE 19701

Mailing address

222 Philadelphia Pike Ste 13
Wilmington, DE 19809-3166
Phone (302) 552-3574

Other names 2

  • Life Health at Wilbur Doing business as
  • The Life Health Center Doing business as

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

4050 Wrangle Hill Rd
Bear, DE 19701
Phone (302) 429-4083

NPI Registry JSON

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535328000000",
    "number": "1174004345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 PHILADELPHIA PIKE STE 13",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198093166",
            "telephone_number": "302-552-3574",
            "fax_number": "302-552-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 WRANGLE HILL RD",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "19701",
            "telephone_number": "302-552-3574",
            "fax_number": "302-552-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE LIFE CENTER COMPLEX, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE LIFE CENTER COMPLEX, INC.",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "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"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Health at Wilbur",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Life Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bear, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; 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.