Provider Demographics
NPI:1811298359
Name:HEALTHY LIVING HOME CARE AGENCY
Entity type:Organization
Organization Name:HEALTHY LIVING HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:NEALY
Authorized Official - Last Name:BELLAMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-840-4559
Mailing Address - Street 1:805 N FRANKLIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-2735
Mailing Address - Country:US
Mailing Address - Phone:910-640-1003
Mailing Address - Fax:910-640-1004
Practice Address - Street 1:805 N FRANKLIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-2735
Practice Address - Country:US
Practice Address - Phone:910-640-1003
Practice Address - Fax:910-640-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health