Provider Demographics
NPI:1326218082
Name:LIVING WELL HEALTHCARE CORPORATION
Entity Type:Organization
Organization Name:LIVING WELL HEALTHCARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:TINGLIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:727-560-8524
Mailing Address - Street 1:1838 RAVEN GLEN DR
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33570-3219
Mailing Address - Country:US
Mailing Address - Phone:727-560-8524
Mailing Address - Fax:
Practice Address - Street 1:1838 RAVEN GLEN DR
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33570-3219
Practice Address - Country:US
Practice Address - Phone:727-560-8524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-08
Last Update Date:2008-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management