Provider Demographics
NPI:1770351256
Name:LIVING PROOF HOMEHEALTH CARE LLC
Entity type:Organization
Organization Name:LIVING PROOF HOMEHEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PEACE
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAMI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-609-6349
Mailing Address - Street 1:228 CALLAGHAN DR
Mailing Address - Street 2:
Mailing Address - City:FATE
Mailing Address - State:TX
Mailing Address - Zip Code:75189-4929
Mailing Address - Country:US
Mailing Address - Phone:214-609-6349
Mailing Address - Fax:
Practice Address - Street 1:228 CALLAGHAN DR
Practice Address - Street 2:
Practice Address - City:FATE
Practice Address - State:TX
Practice Address - Zip Code:75189-4929
Practice Address - Country:US
Practice Address - Phone:214-609-6349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health