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General NPI Number Information
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NPI Number | 1841441631
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Entity Type | Organization
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Legal Business Name | LIVING WELL HOME CARE, LLC.
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Dates
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Enumeration Date | 10/10/2008
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Last Update Date | 09/27/2011
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Provider Practice Location Address
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Address Line | 16341 NW 17TH ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1722
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Country | US
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Telephone | 305-479-2412
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Fax | 305-433-7024
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Provider Business Mailing Address
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Address Line | 18350 NW 2ND AVE SUITE NO. 503
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-4519
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Country | US
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Telephone | 305-479-2412
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Fax | 305-433-7024
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. GUY-ALAIN ISMA
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Credential |
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Telephone | 305-432-3282
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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 |
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License Number State |
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