Provider Demographics
NPI:1619563210
Name:BETTER LIFESTYLES RESIDENTIAL SERVICES LLC
Entity Type:Organization
Organization Name:BETTER LIFESTYLES RESIDENTIAL SERVICES LLC
Other - Org Name:BETTER LIFESTYLES RESIDENTIAL SERVICES LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:EDMONDSON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:330-418-8939
Mailing Address - Street 1:127 23RD ST NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-3917
Mailing Address - Country:US
Mailing Address - Phone:330-418-8939
Mailing Address - Fax:330-956-5696
Practice Address - Street 1:127 23RD ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-3917
Practice Address - Country:US
Practice Address - Phone:330-418-8939
Practice Address - Fax:330-956-5696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-17
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care