Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Authentic Life Center LLC

Organization Clinical Social Worker · NPI 1871102673

Authentic Life Center LLC is a Clinical Social Worker in Niles, Michigan. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

210 E Main St Ste 16
Niles, MI 49120-2376
Phone: (269) 409-1276
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1871102673
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tiffany Russell — Owner · (574) 323-6996
NPI enumeratedJuly 28, 2020
Last updated in NPPESJuly 28, 2020
Certification dateJuly 28, 2020
Mailing address78 Sunset Ln, Niles, MI 49120-9344

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