Aging Superbly LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

AGING SUPERBLY LLC

Practice address

3510 Helen Ave
Lincoln Park, MI 48146-3462

Phone

(313) 402-1158

NPI assigned

Mar 14, 2025

Organization subpart

No

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

Authorized official

Name

Petrina Gonder

Title

Owner

Phone

(313) 402-1158

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741910400000",
    "number": "1790585206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 HELEN AVE",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481463462",
            "telephone_number": "313-402-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 HELEN AVE",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481463462",
            "telephone_number": "313-402-1158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGING SUPERBLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A",
        "authorized_official_last_name": "GONDER",
        "authorized_official_first_name": "PETRINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-402-1158"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.