Provider Demographics
NPI:1154487643
Name:LIVING LIFE, LLC
Entity Type:Organization
Organization Name:LIVING LIFE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:F
Authorized Official - Last Name:DAUGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-736-5843
Mailing Address - Street 1:PO BOX 6810
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59406
Mailing Address - Country:US
Mailing Address - Phone:406-216-3100
Mailing Address - Fax:
Practice Address - Street 1:1601 2ND AVE N STE 116
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3286
Practice Address - Country:US
Practice Address - Phone:406-216-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty