NPIMap

Organization Active NPI

Live Well Health LLC

  • Clinic/Center
  • Southfield, MI
National Provider Identifier
1548627847
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LIVE WELL HEALTH LLC
Practice address
15565 Northland Dr
Suite 103W-B
Southfield, MI 48075
Phone
(248) 809-2094
NPI assigned
Jan 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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

Authorized official

Name
Mr. Sissy Tezera, DC
Title
Owner
Phone
(248) 809-2094

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

15565 Northland Dr
Suite 103W-B
Southfield, MI 48075

Mailing address

15565 Northland Dr
Suite 103W-B
Southfield, MI 48075
Phone (248) 809-2094

National Provider Directory

National Provider Directory

Locations

15565 Northland Dr W
Ste 1
Southfield, MI 48075
Phone (248) 809-2094

15565 Northland Dr W
Ste 103WB
Southfield, MI 48075
Phone (248) 809-2094

NPI Registry JSON

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453161600000",
    "number": "1548627847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15565 NORTHLAND DR",
            "address_2": "SUITE 103W-B",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48075",
            "telephone_number": "248-809-2094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15565 NORTHLAND DR",
            "address_2": "SUITE 103W-B",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48075",
            "telephone_number": "248-809-2094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE WELL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-19",
        "last_updated": "2016-01-19",
        "status": "A",
        "authorized_official_last_name": "TEZERA",
        "authorized_official_first_name": "SISSY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-809-2094",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; 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.