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General NPI Number Information
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NPI Number | 1134809429
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Entity Type | Organization
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Legal Business Name | LIVINGSPRING HEALTH AND WELLNESS CENTER LLC
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Dates
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Enumeration Date | 07/20/2023
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 5706 TURNEY RD STE 300
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City | GARFIELD HEIGHTS
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State | OH
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Zip | 44125-3928
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Country | US
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Telephone | 216-854-2013
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Fax |
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Provider Business Mailing Address
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Address Line | 12401 ROCKSIDE RD UNIT 25171
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City | CLEVELAND
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State | OH
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Zip | 44125-7307
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Country | US
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Telephone | 216-854-2013
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ANTHONIA NDALI CHUKWUDELUNZU
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Credential | FNP
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Telephone | 216-854-2013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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