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General NPI Number Information
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NPI Number | 1649947748
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Entity Type | Organization
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Legal Business Name | HEALTHY LIVING ORGANIZATION, INC.
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Dates
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Enumeration Date | 08/26/2021
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Last Update Date | 08/26/2021
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Provider Practice Location Address
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Address Line | 24 BEACH ST APT 3
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City | QUINCY
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State | MA
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Zip | 02170-2857
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Country | US
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Telephone | 781-654-5522
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Fax |
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Provider Business Mailing Address
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Address Line | 24 BEACH ST APT 3
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City | QUINCY
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State | MA
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Zip | 02170-2857
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Country | US
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Telephone | 781-654-5522
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NICK KRASILNIKOV SR.
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Credential | ND
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Telephone | 781-654-5522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282J00000X
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Taxonomy Name | Religious Nonmedical Health Care Institution
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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