Provider Demographics
NPI:1396822748
Name:WONDERFUL LIVING INC.
Entity Type:Organization
Organization Name:WONDERFUL LIVING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TERI
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:COLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-739-0330
Mailing Address - Street 1:102 E MOORE AVE
Mailing Address - Street 2:SUITE 214
Mailing Address - City:TERRELL
Mailing Address - State:TX
Mailing Address - Zip Code:75160-3204
Mailing Address - Country:US
Mailing Address - Phone:214-739-0330
Mailing Address - Fax:972-524-7337
Practice Address - Street 1:102 E MOORE AVE
Practice Address - Street 2:SUITE 214
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-3204
Practice Address - Country:US
Practice Address - Phone:214-739-0330
Practice Address - Fax:972-524-7337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1270830001Medicare ID - Type Unspecified