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General NPI Number Information
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NPI Number | 1134907983
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Entity Type | Organization
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Legal Business Name | BETTER LIVING WELLNESS LLC.
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Dates
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Enumeration Date | 09/21/2023
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 7725 N 43RD AVE STE 621
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City | PHOENIX
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State | AZ
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Zip | 85051-5772
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Country | US
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Telephone | 628-934-3784
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Fax |
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Provider Business Mailing Address
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Address Line | 6271 GOLDEN RAIN ST
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89031-1833
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Country | US
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Telephone | 702-672-6478
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATION OFFICER
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Name | DONIESHA SMITH
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Credential |
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Telephone | 702-672-6478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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