NPIMap

Organization Active NPI

The Life Center Complex, Inc

  • Student Health Clinic/Center
  • New Castle, DE
National Provider Identifier
1467939082
Registry record updated Jul 26, 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
Practice address
27 Landers LN
New Castle, DE 19720-2022
Phone
(302) 429-4083
Fax
(302) 429-4078
NPI assigned
Jul 26, 2018
Organization subpart
Yes
Parent organization
THE LIFE CENTER COMPLEX, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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

Authorized official

Name
Mr. Forrest Watson III, MBA
Title
Ceo
Phone
(302) 552-3574

Specialties & licenses 1

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

Addresses

Primary practice location

27 Landers LN
New Castle, DE 19720-2022

Mailing address

222 Philadelphia Pike Ste 13-15
Wilmington, DE 19809-3166
Phone (302) 552-3574

Other names 2

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

27 Landers Ln
New Castle, DE 19720
Phone (302) 429-4083

222 Philadelphia Pike
Ste 1315
Wilmington, DE 19809

NPI Registry JSON

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532563200000",
    "number": "1467939082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 PHILADELPHIA PIKE STE 13-15",
            "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": "27 LANDERS LN",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197202022",
            "telephone_number": "302-429-4083",
            "fax_number": "302-429-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE LIFE CENTER COMPLEX, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE LIFE CENTER COMPLEX, INC",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-07-26",
        "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",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "DE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Life Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Life Health Center at Eisenberg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Castle, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.