Provider Demographics
NPI:1831425735
Name:LIVING SMART, LLC
Entity type:Organization
Organization Name:LIVING SMART, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:KEATS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-343-0657
Mailing Address - Street 1:11681 STERLING AVE
Mailing Address - Street 2:SUITE H
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-4972
Mailing Address - Country:US
Mailing Address - Phone:951-343-0657
Mailing Address - Fax:951-343-1284
Practice Address - Street 1:11681 STERLING AVE
Practice Address - Street 2:SUITE H
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-4972
Practice Address - Country:US
Practice Address - Phone:951-343-0657
Practice Address - Fax:951-343-1284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care