Provider Demographics
NPI:1891096681
Name:LIVINGWELL HOME CARE INC
Entity Type:Organization
Organization Name:LIVINGWELL HOME CARE INC
Other - Org Name:CAROLINA MEDICAL STAFFING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:984-233-1334
Mailing Address - Street 1:843 THE VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6863
Mailing Address - Country:US
Mailing Address - Phone:984-233-1334
Mailing Address - Fax:
Practice Address - Street 1:843 THE VILLAGE CIR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6863
Practice Address - Country:US
Practice Address - Phone:984-233-1334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-09
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 251S00000X, 253Z00000X, 385H00000X
SC251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health
No385H00000XRespite Care FacilityRespite Care