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General NPI Number Information
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NPI Number | 1366317372
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Entity Type | Organization
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Legal Business Name | WELL LIVING GROUP LLC
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Dates
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Enumeration Date | 10/08/2025
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 1425 S C TER
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City | LAKE WORTH BEACH
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State | FL
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Zip | 33460-5338
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Country | US
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Telephone | 786-290-1943
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Fax | 786-290-1943
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Provider Business Mailing Address
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Address Line | 1425 S C TER
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City | LAKE WORTH BEACH
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State | FL
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Zip | 33460-5338
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Country | US
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Telephone | 786-290-1943
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Fax | 786-290-1943
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Authorized Official
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Title or Position | DIRECTOR
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Name | LEKISHA WHITE
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Credential |
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Telephone | 786-290-1943
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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