Provider Demographics
NPI:1790193506
Name:LIVING BETTER BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:LIVING BETTER BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:MOSES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:573-785-5224
Mailing Address - Street 1:2725 N WESTWOOD BLVD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-2346
Mailing Address - Country:US
Mailing Address - Phone:573-785-5224
Mailing Address - Fax:
Practice Address - Street 1:2725 N WESTWOOD BLVD
Practice Address - Street 2:SUITE 8
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-2346
Practice Address - Country:US
Practice Address - Phone:573-785-5224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007025653251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1073811139Medicaid
MO1073811139OtherNPI
12320676OtherCAQH
MO175700004Medicare PIN
MO106540008Medicare PIN