MEDICARE: LIVING WITHOUT LIMITS HOME MODIFICATION AND ACCESSIBILITY, 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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1437774502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVING WITHOUT LIMITS HOME MODIFICATION AND ACCESSIBILITY, LLC

Provider Business Mailing Address
First Line	:	4603 CRADDLE HILL DR
Second Line	:
City	:	BARTLETT
State	:	TN
Zip	:	38002-1501
Country	:	US
Telephone Number	:	901-487-2039
Fax Number	:

Provider Business Practice Location Address
First Line	:	4603 CRADDLE HILL DR
Second Line	:
City	:	BARTLETT
State	:	TN
Zip	:	38002-1501
Country	:	US
Telephone Number	:	901-487-2039
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALISHIA E. HEASTON
Credential	:	OTR/L
Telephone Number	:	901-487-2039

Provider Enumeration Date	:	06/14/2020
Last Update Date	:	06/14/2020

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