Provider Demographics
NPI:1477146991
Name:ENLIVEN SPECIALTY NURSING, LLC
Entity Type:Organization
Organization Name:ENLIVEN SPECIALTY NURSING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDINGIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:623-853-7234
Mailing Address - Street 1:700 N ESTRELLA PKWY STE 235
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-9332
Mailing Address - Country:US
Mailing Address - Phone:623-478-2797
Mailing Address - Fax:
Practice Address - Street 1:1567 DAILY DR
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-7233
Practice Address - Country:US
Practice Address - Phone:623-478-2797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion