Life Centers of America LLC

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

Phone

(443) 819-6350

NPI assigned

Mar 4, 2013

Last updated

Mar 8, 2019By 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

Mr. Josiah Malik Jackson

Title

Vice - President

Phone

(443) 473-8876

Specialties & licenses 2

Addresses

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.

• Life Centers of America LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Parkville, MD
  • NPI 1295293124
  NPD tax ID

Locations

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

{
    "created_epoch": "1362355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552003200000",
    "number": "1477894202",
    "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": "410-497-4514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8509 HARFORD RD",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "21234",
            "telephone_number": "443-819-6350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1410 Bush St",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212301939",
            "country_code": "US",
            "telephone_number": "443-804-4405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFE CENTERS OF AMERICA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-04",
        "last_updated": "2019-03-08",
        "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": "443-473-8876",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DO Yeon Lee, RD, LDN, CNSC
• Jonathan Bud Leligdowicz, PHARMD
• Zachary Leppert, RPH
• Letitia J. Wright, MD, Inc.
• Life Centers of America LLC
• Lifebridge Community Physicians, Inc (LifeBridge Health Pediatrics of Parkville)
• Lifting Stigmas and Changing Lives
• Lifting Stigmas and Changing Lives
• Lifting Stigmas and Changing Lives
• Norma Rae Lockett, NURSE

• Mental Health Clinic/Center (Including Community Mental Health Center) in Parkville, MD
• Providers in Parkville, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.