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General NPI Number Information
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NPI Number | 1508304965
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Entity Type | Organization
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Legal Business Name | LIVING LIFE AT HOME, LLC
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Dates
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Enumeration Date | 02/06/2017
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Last Update Date | 02/06/2017
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Provider Practice Location Address
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Address Line | 685 BERNARD ST
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City | CLAYTON
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State | NJ
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Zip | 08312-1770
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Country | US
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Telephone | 856-230-2396
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Fax | 856-997-9828
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Provider Business Mailing Address
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Address Line | 685 BERNARD ST
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City | CLAYTON
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State | NJ
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Zip | 08312-1770
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Country | US
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Telephone | 856-230-2396
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Fax | 856-997-9828
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MS. JANICE MARIE HOLLAND-CROSS
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Credential |
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Telephone | 856-230-2396
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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 | HP0246400
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License Number State | NJ
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