Century Living Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801080744 Issued in MI

Legal business name

CENTURY LIVING INC

Doing business as

Conner Creek Life Solutions LLC

Practice address

4777 E Outer Dr
Detroit, MI 48234-3241

Phone

(313) 369-5800

Fax

(313) 859-2000

NPI assigned

Jun 22, 2015

Last updated

Feb 25, 2022By 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

Andrew McLemore Jr.

Title

Ceo

Phone

(313) 369-5098

Specialties & licenses 6

Addresses

Other identifiers 1

Other names 1

• Conner Creek Life Solutions LLC Doing business as

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1659753085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4777 E OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482343241",
            "telephone_number": "313-369-5800",
            "fax_number": "313-859-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4777 E OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482343241",
            "telephone_number": "313-369-5800",
            "fax_number": "313-859-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTURY LIVING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-22",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "MCLEMORE",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-369-5098",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801080744",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659753085",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conner Creek Life Solutions LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Lina Cepeda, CRNA
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• Clare E Ceresnie, MS, OTR/L
• Mirela Cerghet, M.D., PH.D.

• Clinical Social Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.