Provider Demographics
NPI:1982012019
Name:HEALTHY LIVING AT HOME LLC
Entity Type:Organization
Organization Name:HEALTHY LIVING AT HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:VERHOEVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-551-0846
Mailing Address - Street 1:2365 NORTHSIDE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-2720
Mailing Address - Country:US
Mailing Address - Phone:888-871-0766
Mailing Address - Fax:866-551-0846
Practice Address - Street 1:39899 BALENTINE DR
Practice Address - Street 2:SUITE 314
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-5355
Practice Address - Country:US
Practice Address - Phone:408-324-0600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-01
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health