Provider Demographics
NPI:1053134817
Name:LIVING WELL HEALTH CARE SERVICES LLC
Entity type:Organization
Organization Name:LIVING WELL HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MHP
Authorized Official - Prefix:
Authorized Official - First Name:PRETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUZEH-BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-400-8460
Mailing Address - Street 1:3390 132ND LN NW
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55448-1070
Mailing Address - Country:US
Mailing Address - Phone:507-400-8468
Mailing Address - Fax:
Practice Address - Street 1:3390 132ND LN NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55448-1070
Practice Address - Country:US
Practice Address - Phone:507-400-8468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes177F00000XOther Service ProvidersLodging
No174200000XOther Service ProvidersMeals
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care