Provider Demographics
NPI:1164658514
Name:LIVING WELL HOME HEALTH CARE INC.
Entity Type:Organization
Organization Name:LIVING WELL HOME HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARELIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-599-8070
Mailing Address - Street 1:9600 NW 25TH ST STE 5A
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-1416
Mailing Address - Country:US
Mailing Address - Phone:305-599-8070
Mailing Address - Fax:305-599-8090
Practice Address - Street 1:9600 NW 25TH ST STE 5A
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-1416
Practice Address - Country:US
Practice Address - Phone:305-599-8070
Practice Address - Fax:305-599-8090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health