MEDICARE: CONFIDENT 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	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1629904495
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONFIDENT LIVING LLC

Provider Business Mailing Address
First Line	:	6521 BLUE BIRD LN
Second Line	:
City	:	OLIVE BRANCH
State	:	MS
Zip	:	38654-9624
Country	:	US
Telephone Number	:	601-291-7587
Fax Number	:

Provider Business Practice Location Address
First Line	:	6521 BLUE BIRD LN
Second Line	:
City	:	OLIVE BRANCH
State	:	MS
Zip	:	38654-9624
Country	:	US
Telephone Number	:	601-291-7587
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KEVIN SMITH
Credential	:	OT
Telephone Number	:	601-291-7587

Provider Enumeration Date	:	06/19/2026
Last Update Date	:	06/19/2026

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Directions to “CONFIDENT LIVING LLC ” Practice Location

Language	Start Address	Practice Location

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