Provider Demographics
NPI:1245799410
Name:AWAKEN TO LIFE, LLC
Entity Type:Organization
Organization Name:AWAKEN TO LIFE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CFO
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-478-1443
Mailing Address - Street 1:20 HIGH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-2709
Mailing Address - Country:US
Mailing Address - Phone:513-478-1443
Mailing Address - Fax:
Practice Address - Street 1:20 HIGH ST STE 125
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-2709
Practice Address - Country:US
Practice Address - Phone:513-478-1443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care