Provider Demographics
NPI:1285277814
Name:LANSING SENIOR PARTNERS LLC
Entity type:Organization
Organization Name:LANSING SENIOR PARTNERS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-669-8404
Mailing Address - Street 1:PO BOX 30516
Mailing Address - Street 2:DEPARTMENT #8711
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48909-8016
Mailing Address - Country:US
Mailing Address - Phone:602-331-7006
Mailing Address - Fax:602-491-2072
Practice Address - Street 1:3512 COOLIDGE RD
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-6376
Practice Address - Country:US
Practice Address - Phone:517-318-5889
Practice Address - Fax:517-318-5915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-27
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI332001OtherLARA LICENSE