Renaissance Age Management Institute,LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

4301051672 Issued in MI

Legal business name

RENAISSANCE AGE MANAGEMENT INSTITUTE,LLC

Practice address

29150 Buckingham St
Suite 6
Livonia, MI 48154-7502

Phone

(734) 207-9999

Fax

(734) 943-6009

NPI assigned

Jun 25, 2008

Organization subpart

No

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

Authorized official

Name

Debbie Gamble

Title

Office Manager

Phone

(734) 207-9999

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453939200000",
    "number": "1285895912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29150 BUCKINGHAM ST",
            "address_2": "SUITE 6",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481547502",
            "telephone_number": "734-207-9999",
            "fax_number": "734-943-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29150 BUCKINGHAM ST",
            "address_2": "SUITE 6",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481547502",
            "telephone_number": "734-207-9999",
            "fax_number": "734-943-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE AGE MANAGEMENT INSTITUTE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-25",
        "last_updated": "2016-01-28",
        "status": "A",
        "authorized_official_last_name": "GAMBLE",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "734-207-9999"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301051672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Livonia, MI
• Providers in Livonia, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; 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.