Organization Active NPI

Life Cycles Development Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Akron, OH
National Provider Identifier
1407474737
Registry record updated Jul 13, 2020
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 CYCLES DEVELOPMENT CENTER LLC
Practice address
1507 Copley Rd
Akron, OH 44320-2501
Phone
(234) 571-2163
NPI assigned
Jul 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Authorized official

Name
Andre McCray, LMFTNPI 1770074239
Title
Ceo
Phone
(234) 788-9329

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1507 Copley Rd
Akron, OH 44320-2501

Mailing address

811 Frederick Blvd
Akron, OH 44320-1717
Phone (234) 788-9329

Other identifiers 1

IdentifierTypeStateIssuer
0293192MedicaidOH

National Provider Directory

National Provider Directory

Locations

1507 Copley Rd
Akron, OH 44320
Phone (234) 571-2163

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594598400000",
    "number": "1407474737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 FREDERICK BLVD",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443201717",
            "telephone_number": "234-788-9329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 COPLEY RD",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443202501",
            "telephone_number": "234-571-2163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CYCLES DEVELOPMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-13",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A",
        "authorized_official_last_name": "MCCRAY",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "234-788-9329",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0293192",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.