MEDICARE: LIVING LIFE HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	2126391	OH

General Provider Information

NPI Number	:	1194066795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVING LIFE HOME CARE LLC

Provider Business Mailing Address
First Line	:	2323 LAKE CLUB DR
Second Line	:	SUITE 102
City	:	COLUMBUS
State	:	OH
Zip	:	43232-3198
Country	:	US
Telephone Number	:	614-322-9210
Fax Number	:	614-322-9214

Provider Business Practice Location Address
First Line	:	2323 LAKE CLUB DR STE 102
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-3198
Country	:	US
Telephone Number	:	614-322-3210
Fax Number	:	614-322-9214

Authorized Official
Title or Position	:	NURSE
Name	:	EBENEZER A MENSAH-ADDISON
Credential	:
Telephone Number	:	614-322-9210

Provider Enumeration Date	:	03/06/2013
Last Update Date	:	08/31/2023

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Directions to “LIVING LIFE HOME CARE LLC ” Practice Location

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