Organization Active NPI

Longevity Wellness Group, PLLC

  • Health Service Clinic/Center
  • West Bloomfield, MI
National Provider Identifier
1487597415
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
LONGEVITY WELLNESS GROUP, PLLC
Doing business as
Revive Longevity
Practice address
7479 Middlebelt Rd Ste 3
West Bloomfield, MI 48322-4175
Phone
(248) 387-9414
NPI assigned
Apr 13, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Authorized official

Name
Dr. Brandon Hana, DONPI 1346816774
Title
Owner
Phone
(248) 228-4598

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
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

7479 Middlebelt Rd Ste 3
West Bloomfield, MI 48322-4175

Mailing address

7479 Middlebelt Rd Ste 3
West Bloomfield, MI 48322-4175
Phone (248) 387-9414

Other names 1

  • Revive Longevity Doing business as

National Provider Directory

National Provider Directory

Locations

7479 Middlebelt Rd
Ste 3
West Bloomfield, MI 48322
Phone (248) 387-9414

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": "1776038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776038400000",
    "number": "1487597415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7479 MIDDLEBELT RD STE 3",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224175",
            "telephone_number": "248-387-9414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7479 MIDDLEBELT RD STE 3",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224175",
            "telephone_number": "248-387-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGEVITY WELLNESS GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-13",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A",
        "authorized_official_last_name": "HANA",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-228-4598",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revive Longevity",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; 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.