Organization
LONGEVITY ACCOUNTABLE CARE, PA
Active
Parent organization
LONGEVITY ACCOUNTABLE CARE, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
LONGEVITY ACCOUNTABLE CARE, PA
Authorized official
DIANE VINCUR (PRACTICE MANAGER)
(561) 815-2427
Entity
Organization
Contact information
Practice address
26505 POWERS AVE, DEARBORN HEIGHTS, MI 48125-1327
(313) 291-6200
Mailing address
11780 US HIGHWAY 1 STE N107, PALM BEACH GARDENS, FL 33408-3007
(561) 815-2427
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
05/20/2024
Last updated
05/20/2024
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