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General NPI Number Information
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NPI Number | 1992006266
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Entity Type | Organization
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Legal Business Name | LIFESTYLE LIVING LLC
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Dates
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Enumeration Date | 11/03/2010
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Last Update Date | 10/23/2012
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Provider Practice Location Address
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Address Line | 833 NORTH RAINBOW DRIVE
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City | HOLLYWOOD
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State | FL
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Zip | 33021
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Country | US
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Telephone | 954-926-5894
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Fax | 954-367-7698
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Provider Business Mailing Address
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Address Line | 833 NORTH RAINBOW DRIVE
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City | HOLLYWOOD
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State | FL
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Zip | 33021
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Country | US
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Telephone | 954-894-7958
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Fax | 954-367-7698
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | LINDA CAVALLO
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Credential |
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Telephone | 954-347-6487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 10901
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License Number State | FL
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