Provider Demographics
NPI:1770054116
Name:PERFECTING LIFESTYLES LLC
Entity type:Organization
Organization Name:PERFECTING LIFESTYLES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:JERMAINE
Authorized Official - Last Name:CUMBUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-574-3720
Mailing Address - Street 1:499 MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-2534
Mailing Address - Country:US
Mailing Address - Phone:248-574-3720
Mailing Address - Fax:
Practice Address - Street 1:499 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-2534
Practice Address - Country:US
Practice Address - Phone:248-574-3720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-11
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health