National Provider Identifier Database

PEAK LONGEVITY LLC
Mental Health (Including Community Mental Health Center)


Contact Information

PEAK LONGEVITY LLC
451 STATE ST
NORTH HAVEN, CT06473-3070
Phone: 203-281-4325
Fax: 203-281-4324
Website:
Specialty Taxonomy Code
* Mental Health (Including Community Mental Health Center) 261QM0801X
Clinical 1041C0700X

* Indicates primary specialty

NPI Profile & details for PEAK LONGEVITY LLC

NPI Number 1922596360
Legal business name
LBN
PEAK LONGEVITY LLC
Authorized official DEBORAH MARCUS, LCSW - (DIRECTOR, LCSW)
Entity Organization
Organization subpart No
Enumeration date 04/30/2018
Last updated 04/30/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • CT License #: 005904
  • CT Other: 140005904CT03 ANTHEM BCBS

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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