MEDICARE: WELL IMPROVED LIVING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1215657002
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELL IMPROVED LIVING LLC

Provider Business Mailing Address
First Line	:	5964 S ANTRIM LOOP
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85706-0011
Country	:	US
Telephone Number	:	920-378-7176
Fax Number	:

Provider Business Practice Location Address
First Line	:	5964 S ANTRIM LOOP
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85706-0011
Country	:	US
Telephone Number	:	920-378-7176
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	NDAYISHIMIYE RUSHIMISHA
Credential	:
Telephone Number	:	920-378-7176

Provider Enumeration Date	:	08/31/2022
Last Update Date	:	08/31/2022

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Directions to “WELL IMPROVED LIVING LLC ” Practice Location

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