Provider Demographics
NPI:1942532452
Name:LIVING LIFE
Entity Type:Organization
Organization Name:LIVING LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BARNDT
Authorized Official - Suffix:
Authorized Official - Credentials:CTRS
Authorized Official - Phone:215-803-9743
Mailing Address - Street 1:2661 N SHERMAN ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17406-2331
Mailing Address - Country:US
Mailing Address - Phone:215-803-9743
Mailing Address - Fax:
Practice Address - Street 1:2661 N SHERMAN ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17406-2331
Practice Address - Country:US
Practice Address - Phone:215-803-9743
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA100085927251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health