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General NPI Number Information
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NPI Number | 1265258206
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Entity Type | Organization
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Legal Business Name | LIVING WELL HEALTHCARE SERVICES, LLC
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 9 SEA PINES CT
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City | O FALLON
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State | MO
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Zip | 63368-6687
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Country | US
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Telephone | 314-283-9230
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Fax |
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Provider Business Mailing Address
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Address Line | 9 SEA PINES CT
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City | O FALLON
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State | MO
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Zip | 63368-6687
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Country | US
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Telephone | 314-283-9230
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | TAISHAI SANDERSON
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Credential |
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Telephone | 314-283-9230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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