Provider Demographics
NPI:1982969069
Name:LIVINGWELL HOME HEALTHCARE AGENCY, LLC.
Entity Type:Organization
Organization Name:LIVINGWELL HOME HEALTHCARE AGENCY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZONA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCPHERSON-VINCENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-290-7515
Mailing Address - Street 1:1560 SAWGRASS CORPORATE PKWY
Mailing Address - Street 2:FOURTH FLOOR
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2858
Mailing Address - Country:US
Mailing Address - Phone:954-284-8425
Mailing Address - Fax:
Practice Address - Street 1:1560 SAWGRASS PARKWAY
Practice Address - Street 2:4 FLOOR
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33023
Practice Address - Country:US
Practice Address - Phone:954-290-7515
Practice Address - Fax:954-252-2158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-05
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health