MEDICARE: FOUDATION FOR BETTER LIVING, 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	385H00000X	Respite Care	089319	FL
2	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility	089319	FL

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	:	1598925141
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOUDATION FOR BETTER LIVING, INC

Provider Business Mailing Address
First Line	:	2612 29TH ST SW
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33976-4076
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2612 29TH ST SW
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33976-4076
Country	:	US
Telephone Number	:	239-303-1689
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	EDUARDO LOPEZ
Credential	:
Telephone Number	:	239-303-1689

Provider Enumeration Date	:	06/16/2008
Last Update Date	:	06/16/2008

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