Provider Demographics
NPI:1154015253
Name:HEALTHY LIVING SOLUTIONS LLC
Entity type:Organization
Organization Name:HEALTHY LIVING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:FAGGART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-365-0100
Mailing Address - Street 1:4205 KELLYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-7100
Mailing Address - Country:US
Mailing Address - Phone:980-365-0100
Mailing Address - Fax:
Practice Address - Street 1:150 BW THOMAS DR STE 109
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-7231
Practice Address - Country:US
Practice Address - Phone:980-365-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty