Provider Demographics
NPI:1124850300
Name:LIVING YOUR BEST LIFE SUPPORTIVE SERVICES INC.
Entity type:Organization
Organization Name:LIVING YOUR BEST LIFE SUPPORTIVE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHEREE
Authorized Official - Middle Name:CHARNEL
Authorized Official - Last Name:OJO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:305-990-3922
Mailing Address - Street 1:3999 NW 163RD ST
Mailing Address - Street 2:
Mailing Address - City:OPA LOCKA
Mailing Address - State:FL
Mailing Address - Zip Code:33054-6286
Mailing Address - Country:US
Mailing Address - Phone:305-990-3922
Mailing Address - Fax:
Practice Address - Street 1:3999 NW 163RD ST
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33054-6286
Practice Address - Country:US
Practice Address - Phone:305-990-3922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health