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General NPI Number Information
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NPI Number | 1205447703
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Entity Type | Organization
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Legal Business Name | LIVING WELL CARE
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Dates
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Enumeration Date | 08/10/2020
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Last Update Date | 08/10/2020
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Provider Practice Location Address
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Address Line | 5190 SW 90TH TER APT 12-104
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City | COOPER CITY
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State | FL
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Zip | 33328-5011
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Country | US
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Telephone | 954-415-1757
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Fax | 305-692-1892
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Provider Business Mailing Address
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Address Line | 5190 SW 90TH TER APT 12-104
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City | COOPER CITY
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State | FL
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Zip | 33328-5011
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Country | US
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Telephone | 954-415-1757
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Fax | 305-692-1892
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | DR. PAULINE J VOGLER
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Credential | ED.D
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Telephone | 954-415-1757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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