Healthcare Provider Details
I. General information
NPI: 1508419094
Provider Name (Legal Business Name): UZIMA LIFESTYLE CENTER AND INFORMATION SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/23/2019
Last Update Date: 07/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4601 WINDING WAY
KALAMAZOO MI
49006-1040
US
IV. Provider business mailing address
4601 WINDING WAY
KALAMAZOO MI
49006-1040
US
V. Phone/Fax
- Phone: 269-775-1133
- Fax: 269-775-1133
- Phone: 269-775-1133
- Fax: 269-775-1133
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QC1500X |
| Taxonomy | Community Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JANICE
EMANUEL MCLEAN
Title or Position: DIRECTOR
Credential: PH.D
Phone: 269-775-1133