Provider Demographics
NPI:1255812020
Name:HEALTHY LIVING AT HOME - VANCOUVER, LLC
Entity type:Organization
Organization Name:HEALTHY LIVING AT HOME - VANCOUVER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP, FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-871-0766
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 1:1499 SE TECH CENTER PL STE 140
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-9575
Practice Address - Country:US
Practice Address - Phone:360-859-4886
Practice Address - Fax:360-859-4891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-28
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health