Provider Demographics
NPI:1134809429
Name:LIVINGSPRING HEALTH AND WELLNESS CENTER LLC
Entity type:Organization
Organization Name:LIVINGSPRING HEALTH AND WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONIA
Authorized Official - Middle Name:NDALI
Authorized Official - Last Name:CHUKWUDELUNZU
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:216-854-2013
Mailing Address - Street 1:12401 ROCKSIDE RD UNIT 25171
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44125-7307
Mailing Address - Country:US
Mailing Address - Phone:216-854-2013
Mailing Address - Fax:
Practice Address - Street 1:5706 TURNEY RD STE 300
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-3928
Practice Address - Country:US
Practice Address - Phone:216-854-2013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No251E00000XAgenciesHome Health
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility