Provider Demographics
NPI:1194378729
Name:POSITIVE LIVING LLC
Entity Type:Organization
Organization Name:POSITIVE LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARYN
Authorized Official - Middle Name:RANA
Authorized Official - Last Name:LANDRETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-258-4035
Mailing Address - Street 1:3114 N BRUSH CREEK ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-8739
Mailing Address - Country:US
Mailing Address - Phone:316-258-4035
Mailing Address - Fax:
Practice Address - Street 1:3114 N BRUSH CREEK ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-8739
Practice Address - Country:US
Practice Address - Phone:316-258-4035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty