Organization Active NPI

Life Centers of America LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Parkville, MD
National Provider Identifier
1295293124
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LIFE CENTERS OF AMERICA LLC
Practice address
8509 Harford Rd
Parkville, MD 21234-4619
Phone
(443) 819-6350
NPI assigned
Mar 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Authorized official

Name
Josiah Malik Jackson
Title
Vice President
Phone
(443) 819-6350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

8509 Harford Rd
Parkville, MD 21234-4619

Mailing address

8509 Harford Rd
Parkville, MD 21234-4619
Phone (443) 819-6350

National Provider Directory

National Provider Directory
Tax ID family
Life Centers of America LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552262400000",
    "number": "1295293124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8509 HARFORD RD",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212344619",
            "telephone_number": "443-819-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8509 HARFORD RD",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212344619",
            "telephone_number": "443-819-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CENTERS OF AMERICA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-03-11",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JOSIAH",
        "authorized_official_middle_name": "MALIK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "443-819-6350"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.