Provider Demographics
NPI:1477148351
Name:LIVING FREE TO BE US HOUSING AND HOME CARE LLC
Entity Type:Organization
Organization Name:LIVING FREE TO BE US HOUSING AND HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LNA
Authorized Official - Phone:623-221-3625
Mailing Address - Street 1:10401 N CAVE CREEK RD LOT 310
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-1601
Mailing Address - Country:US
Mailing Address - Phone:623-221-3625
Mailing Address - Fax:
Practice Address - Street 1:10401 N CAVE CREEK RD LOT 310
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-1601
Practice Address - Country:US
Practice Address - Phone:623-221-3625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health