Healthcare Provider Details

I. General information

NPI: 1265368955
Provider Name (Legal Business Name): THE LIVING WELLS COMMUNITY AND DEVELOPMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

336 E 243RD ST
EUCLID OH
44123-1403
US

IV. Provider business mailing address

336 E 243RD ST
EUCLID OH
44123-1403
US

V. Phone/Fax

Practice location:
  • Phone: 440-755-0299
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY WILSON
Title or Position: EXECUTIVE DIRECTOR
Credential: LSW
Phone: 440-755-0299