MEDICARE: LIVING IN FAMILY ENVIRONMENTS, INC.

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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528660461
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVING IN FAMILY ENVIRONMENTS, INC.

Provider Business Mailing Address
First Line	:	142 N HIGH ST
Second Line	:
City	:	GAHANNA
State	:	OH
Zip	:	43230-3032
Country	:	US
Telephone Number	:	614-475-5305
Fax Number	:	614-471-6912

Provider Business Practice Location Address
First Line	:	142 N HIGH ST
Second Line	:
City	:	GAHANNA
State	:	OH
Zip	:	43230-3032
Country	:	US
Telephone Number	:	614-475-5305
Fax Number	:	614-471-6912

Authorized Official
Title or Position	:	COO
Name	:	MR. JAMES BENJAMIN WESTLAKE II
Credential	:
Telephone Number	:	614-475-5305

Provider Enumeration Date	:	11/16/2020
Last Update Date	:	11/16/2020

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