Provider Demographics
NPI:1386292779
Name:MINDFUL LIVING & CARE, LLC
Entity type:Organization
Organization Name:MINDFUL LIVING & CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GOELZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-299-0956
Mailing Address - Street 1:1147 BROOKFOREST AVE # 252
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60404-8845
Mailing Address - Country:US
Mailing Address - Phone:708-299-0956
Mailing Address - Fax:815-265-6615
Practice Address - Street 1:8204 COOP AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60431-5400
Practice Address - Country:US
Practice Address - Phone:708-299-0956
Practice Address - Fax:815-265-6615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-28
Last Update Date:2022-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251V00000XAgenciesVoluntary or Charitable
No347C00000XTransportation ServicesPrivate Vehicle
No385H00000XRespite Care FacilityRespite Care
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child