Longevity Health Services LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

LONGEVITY HEALTH SERVICES LLC

Practice address

2866 Port Royal LN
Decatur, GA 30034-2767

Phone

(470) 284-1253

NPI assigned

Dec 4, 2024

Last updated

Feb 4, 2025By 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

Shanesia Salmon

Title

Part Owner

Phone

(470) 823-6497

Specialties & licenses 5

Addresses

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

{
    "created_epoch": "1733270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738627200000",
    "number": "1578379624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2866 PORT ROYAL LN",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300342767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2866 PORT ROYAL LN",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300342767",
            "telephone_number": "470-284-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGEVITY HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-04",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A",
        "authorized_official_last_name": "SALMON",
        "authorized_official_first_name": "SHANESIA",
        "authorized_official_title_or_position": "PART OWNER",
        "authorized_official_telephone_number": "470-823-6497"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mary Lopez, MS, BCBA

• Home Health Agency in Decatur, GA
• Providers in Decatur, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.