Provider Demographics
NPI:1679067961
Name:SERVICES FOR LIVING WELL LLC
Entity Type:Organization
Organization Name:SERVICES FOR LIVING WELL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOSA PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:305-608-6462
Mailing Address - Street 1:210 174TH ST APT 2212
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3345
Mailing Address - Country:US
Mailing Address - Phone:305-608-6462
Mailing Address - Fax:
Practice Address - Street 1:16837 NW 91ST CT
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33018-6328
Practice Address - Country:US
Practice Address - Phone:305-608-6462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW11101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty