# LSD CENTER OF EXCELLENCE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LSD Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649160375
- **Authorized official:** MRS. KIMBERLY S AGIM ANP-BC (NURSE PRACTITIONER)
- **Authorized official phone:** (616) 540-9365

## Contact information

- **Practice address:** 200 WOODLAND PASS STE D, EAST LANSING, MI 48823-2000
- **Practice address phone:** (616) 540-9365
- **Mailing address:** 3024 BONITA DR SE, GRAND RAPIDS, MI 49508-1424
- **Mailing address phone:** (616) 540-9365

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207SG0201X | Clinical Genetics (M.D.) Physician | — | NULL | Yes |
| 207SG0201X | Clinical Genetics (M.D.) Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/04/2025
- **Last updated:** 07/04/2025