Provider Demographics
NPI:1396538831
Name:ILLUSTRIOUS LIVING LLC./ MAE WE CARE
Entity type:Organization
Organization Name:ILLUSTRIOUS LIVING LLC./ MAE WE CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DIRECTOR OF INNOVATION
Authorized Official - Prefix:MR
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTON
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:513-238-4704
Mailing Address - Street 1:677 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-2315
Mailing Address - Country:US
Mailing Address - Phone:513-238-4704
Mailing Address - Fax:
Practice Address - Street 1:677 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-2315
Practice Address - Country:US
Practice Address - Phone:513-238-4704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-27
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty