Provider Demographics
NPI:1689344525
Name:LIVING SPRING HOME HEALTH LLC
Entity Type:Organization
Organization Name:LIVING SPRING HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDE
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOGBENIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-526-0534
Mailing Address - Street 1:4212 CRAIGHILL LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-6913
Mailing Address - Country:US
Mailing Address - Phone:781-526-0534
Mailing Address - Fax:
Practice Address - Street 1:624 MATTHEWS MINT HILL RD STE 624-030
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-1761
Practice Address - Country:US
Practice Address - Phone:781-526-0534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health