Provider Demographics
NPI:1821887449
Name:LONGEVITY PERSONAL CARE LLC
Entity type:Organization
Organization Name:LONGEVITY PERSONAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTHCARE PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCKEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-904-3032
Mailing Address - Street 1:PO BOX 5155
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48205-0155
Mailing Address - Country:US
Mailing Address - Phone:248-904-3032
Mailing Address - Fax:
Practice Address - Street 1:19271 REDFERN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-1854
Practice Address - Country:US
Practice Address - Phone:248-904-3032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care