Provider Demographics
NPI:1194066795
Name:LIVING LIFE HOME CARE LLC
Entity type:Organization
Organization Name:LIVING LIFE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:
Authorized Official - First Name:EBENEZER
Authorized Official - Middle Name:A
Authorized Official - Last Name:MENSAH-ADDISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-322-9210
Mailing Address - Street 1:2323 LAKE CLUB DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-3198
Mailing Address - Country:US
Mailing Address - Phone:614-322-9210
Mailing Address - Fax:614-322-9214
Practice Address - Street 1:2323 LAKE CLUB DR STE 102
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-3198
Practice Address - Country:US
Practice Address - Phone:614-322-3210
Practice Address - Fax:614-322-9214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2126391251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health