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NPI Code Detail

MEDICARE: UNITED LIFESTYLES

MEDICARE: UNITED LIFESTYLES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251K00000XPublic Health or Welfare Agency

General Provider Information

NPI Number : 1396743811
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNITED LIFESTYLES
Provider Business Mailing Address
First Line : 407 S NELSON ST
Second Line :
City : GREENVILLE
State : MI
Zip : 48838-2138
Country : US
Telephone Number : 616-754-6185
Fax Number :
Provider Business Practice Location Address
First Line : 407 S NELSON ST
Second Line :
City : GREENVILLE
State : MI
Zip : 48838-2138
Country : US
Telephone Number : 616-754-6185
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : JODIE FABER
Credential :
Telephone Number : 616-754-6185
Provider Enumeration Date : 07/08/2005
Last Update Date : 08/22/2020

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Directions to “UNITED LIFESTYLES ” Practice Location

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