Provider Demographics
NPI:1396011870
Name:HEALTHY LIVING AT HOME-SAN DIEGO LLC
Entity Type:Organization
Organization Name:HEALTHY LIVING AT HOME-SAN DIEGO LLC
Other - Org Name:MISSION HOME HEALTH OF NORTH COUNTY SAN DIEGO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-871-0766
Mailing Address - Street 1:2365 NORTHSIDE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-2720
Mailing Address - Country:US
Mailing Address - Phone:888-871-0766
Mailing Address - Fax:866-551-0846
Practice Address - Street 1:334 VIA VERA CRUZ STE 150
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2638
Practice Address - Country:US
Practice Address - Phone:855-804-8560
Practice Address - Fax:858-412-1987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health