# LIFELONG MEDICAL CARE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LIFELONG MEDICAL CARE
- **Other names:** LifeLong William Jenkins Health Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1407973043
- **Legal business name:** LIFELONG MEDICAL CARE
- **Authorized official:** DAVID B. VLIET (CEO)
- **Authorized official phone:** (510) 981-4123

## Contact information

- **Practice address:** 150 HARBOUR WAY, RICHMOND, CA 94801-3554
- **Practice address phone:** (510) 237-9537
- **Practice address fax:** (510) 981-4191
- **Mailing address:** PO BOX 11247, BERKELEY, CA 94712-2247
- **Mailing address phone:** (510) 981-4100
- **Mailing address fax:** (510) 981-4193

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | 550000122 | CA | Yes |
| 261QD0000X | Dental Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 03/26/2007
- **Last updated:** 01/19/2021