Provider Demographics
NPI:1083957401
Name:LIVING AT HOME LLC
Entity Type:Organization
Organization Name:LIVING AT HOME LLC
Other - Org Name:AT HOME HEALTHCARE SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LA SHAWNA
Authorized Official - Middle Name:C
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:330-608-0210
Mailing Address - Street 1:591 ARDELLA AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-2515
Mailing Address - Country:US
Mailing Address - Phone:330-608-0210
Mailing Address - Fax:330-786-0838
Practice Address - Street 1:1630 SCHILLER AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-1756
Practice Address - Country:US
Practice Address - Phone:330-928-4945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-03
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2156841251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health