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General NPI Number Information
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NPI Number | 1538461959
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Entity Type | Organization
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Legal Business Name | OPULENT LIVING INC
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Dates
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Enumeration Date | 11/18/2010
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Last Update Date | 11/18/2010
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Provider Practice Location Address
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Address Line | 3971 NW 122ND TER
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City | SUNRISE
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State | FL
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Zip | 33323-3364
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Country | US
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Telephone | 954-297-3424
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Fax | 954-533-8528
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Provider Business Mailing Address
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Address Line | 8221 NW 54TH CT
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City | LAUDERHILL
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State | FL
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Zip | 33351-4965
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Country | US
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Telephone | 954-297-3424
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Fax | 954-533-8528
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Authorized Official
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Title or Position | CEO
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Name | MR. MICHAEL RICARDO BELLAMY
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Credential |
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Telephone | 954-297-3424
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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 | 688265096
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 688265098
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License Number State | FL
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