| Longevity Nc, Llc | |
|
2006 Belleforest Ct Waxhaw NC 28173-7381 | |
| (804) 800-2500 | |
| (804) 800-2600 |
| Full Name | Longevity Nc, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2006 Belleforest Ct, Waxhaw, North Carolina |
| Authorized Official Name and Position | Anthony Tyler (CO-OWNER) |
| Authorized Official Contact | 8048002500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Longevity Nc, Llc 2006 Belleforest Ct Waxhaw NC 28173-7381 Ph: (804) 800-2500 | Longevity Nc, Llc 2006 Belleforest Ct Waxhaw NC 28173-7381 Ph: (804) 800-2500 |
| NPI Number | 1174467179 |
|---|---|
| Provider Enumeration Date | 04/18/2026 |
| Last Update Date | 04/29/2026 |
| Certification Date | 04/29/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174467179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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