Provider Demographics
NPI:1073065124
Name:HEALTHY LIVING
Entity Type:Organization
Organization Name:HEALTHY LIVING
Other - Org Name:LCM HHA LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-431-2880
Mailing Address - Street 1:1466 BEACH AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-3619
Mailing Address - Country:US
Mailing Address - Phone:347-431-2880
Mailing Address - Fax:347-281-7740
Practice Address - Street 1:1466 BEACH AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-3619
Practice Address - Country:US
Practice Address - Phone:347-431-2880
Practice Address - Fax:347-281-7740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care