Life Care 360, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

LIFE CARE 360, LLC

Practice address

12914 Broadway Ave
Garfield Heights, OH 44125-1859

Phone

(216) 848-9123

NPI assigned

Apr 16, 2020

Last updated

Apr 16, 2020By 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

Kenyatta Vance-Anderson

Title

Ceo

Phone

(216) 848-9123

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586995200000",
    "number": "1275153579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12914 BROADWAY AVE",
            "city": "GARFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441251859",
            "telephone_number": "216-848-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12914 BROADWAY AVE",
            "city": "GARFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441251859",
            "telephone_number": "216-848-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CARE 360, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-16",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A",
        "authorized_official_last_name": "VANCE-ANDERSON",
        "authorized_official_first_name": "KENYATTA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "216-848-9123"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.lifecare360llc@gmail.com",
            "affiliation": "N",
            "address_1": "12914 Broadway Ave",
            "city": "Garfield Heights",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441251859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Leanne Levenduski, ATC
• Michael Maurice Levinson, MD
• Ariona Lewis
• Caitlin Lewis, MD
• Elaine Lewis
• Lincare Inc
• Judah R Lindenberg, M.D.
• Jacqueline Linen
• Amanda Marie Liptak, RDN
• Livingspring Health and Wellness Center LLC

• Primary Care Clinic/Center in Garfield Heights, OH
• Providers in Garfield Heights, OH by specialty
• Primary Care Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; 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.