Provider Demographics
NPI:1316745615
Name:LIVING WISE COMMUNITY SERVICES LLC
Entity type:Organization
Organization Name:LIVING WISE COMMUNITY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:FRITZNEL
Authorized Official - Last Name:MERISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-982-1457
Mailing Address - Street 1:12231 TAYLORS WAY
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-9964
Mailing Address - Country:US
Mailing Address - Phone:347-982-1457
Mailing Address - Fax:
Practice Address - Street 1:360 E COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-1168
Practice Address - Country:US
Practice Address - Phone:347-982-1457
Practice Address - Fax:347-982-1457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health