Provider Demographics
NPI:1841441631
Name:LIVING WELL HOME CARE, LLC.
Entity type:Organization
Organization Name:LIVING WELL HOME CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GUY-ALAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ISMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-432-3282
Mailing Address - Street 1:18350 NW 2ND AVE
Mailing Address - Street 2:SUITE NO. 503
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4519
Mailing Address - Country:US
Mailing Address - Phone:305-479-2412
Mailing Address - Fax:305-433-7024
Practice Address - Street 1:16341 NW 17TH ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1722
Practice Address - Country:US
Practice Address - Phone:305-479-2412
Practice Address - Fax:305-433-7024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-10
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health