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General NPI Number Information
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NPI Number | 1295629525
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Entity Type | Organization
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Legal Business Name | LIFECYCLE II, LLC DBA IMA INC.
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Dates
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Enumeration Date | 06/03/2025
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 4000 PARK RD
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City | CHARLOTTE
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State | NC
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Zip | 28209-2388
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Country | US
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Telephone | 704-529-4411
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Fax |
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Provider Business Mailing Address
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Address Line | 531 S MAIN ST STE 300
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City | GREENVILLE
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State | SC
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Zip | 29601-2556
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Country | US
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Telephone | 803-269-7330
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Fax |
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Authorized Official
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Title or Position | NURSE
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Name | ASHLEY SUMMERS
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Credential | RN
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Telephone | 803-269-7330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number |
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License Number State |
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