Provider Demographics
NPI: | 1144759267 |
---|---|
Name: | ALL WELL LIVING LLC |
Entity Type: | Organization |
Organization Name: | ALL WELL LIVING LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MISS |
Authorized Official - First Name: | ABBAS |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MUKHI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 516-589-2369 |
Mailing Address - Street 1: | 2500 W LAKE MARY BLVD STE 107 |
Mailing Address - Street 2: | |
Mailing Address - City: | LAKE MARY |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32746-3501 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 407-434-1557 |
Mailing Address - Fax: | 407-264-6544 |
Practice Address - Street 1: | 2500 W LAKE MARY BLVD STE 107 |
Practice Address - Street 2: | |
Practice Address - City: | LAKE MARY |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32746-3501 |
Practice Address - Country: | US |
Practice Address - Phone: | 407-434-1557 |
Practice Address - Fax: | 407-264-6544 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2017-06-12 |
Last Update Date: | 2022-07-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | AL13017 | 310400000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility |