Provider Demographics
NPI:1508991845
Name:LIVING IN FULFILLING ENVIRONMENTS, INC.
Entity Type:Organization
Organization Name:LIVING IN FULFILLING ENVIRONMENTS, INC.
Other - Org Name:LIFE, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:BOOKKEEPER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTLAND-KILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-254-2910
Mailing Address - Street 1:PO BOX 449
Mailing Address - Street 2:
Mailing Address - City:TIVERTON
Mailing Address - State:RI
Mailing Address - Zip Code:02878-0449
Mailing Address - Country:US
Mailing Address - Phone:401-254-2910
Mailing Address - Fax:
Practice Address - Street 1:205 BELL AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-3603
Practice Address - Country:US
Practice Address - Phone:401-254-2910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI365315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
RILI51436Medicaid