Organization Active NPI

Living Life Home Care LLC

  • Home Health Agency
  • Columbus, OH
National Provider Identifier
1194066795
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
2126391 Issued in OH
Legal business name
LIVING LIFE HOME CARE LLC
Practice address
2323 Lake Club Dr Ste 102
Columbus, OH 43232-3198
Phone
(614) 322-3210
Fax
(614) 322-9214
NPI assigned
Mar 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ebenezer A Mensah-AddisonNPI 1013324185
Title
Nurse
Phone
(614) 322-9210

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 2126391 OH Primary

Addresses

Primary practice location

2323 Lake Club Dr Ste 102
Columbus, OH 43232-3198

Mailing address

2323 Lake Club Dr
Suite 102
Columbus, OH 43232-3198
Phone (614) 322-9210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131025001524 OH Part A Provider - Home Health Agency 1052546157 Practice locations: Columbus, OH

Home health agency certification: CCN 369102

Legal name
LIVING LIFE HOME CARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 10, 2015
Last certification
Apr 26, 2018
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Aug 7, 2012 in OH
Enrollment address
2323 Lake Club Dr
Ste 102
Columbus, OH 43232-3198

Care Compare: Home health agency

Medicare Care Compare
Listed as
Living Life Homecare LLCCCN 369102
Ownership
Proprietary
Certified
Jan 10, 2015
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

6515 E Livingston Ave
Ste B9
Reynoldsburg, OH 43068
Phone (614) 439-1731

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ebenezer a Mensah-Addison Individual 5% Or Greater Indirect Ownership Interest Aug 7, 2012 100%
General Partnership InterestCeo Aug 7, 2012 100%
Limited Partnership InterestCfo Aug 7, 2012 100%
Corporate OfficerCeo Aug 7, 2012 100%
Corporate DirectorCeo Aug 7, 2012 100%
W-2 Managing EmployeeCeo Aug 7, 2012 100%
Operational/Managerial ControlCeo Aug 7, 2012 100%
OtherCfo Aug 7, 2012

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693440000000",
    "number": "1194066795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 LAKE CLUB DR",
            "address_2": "SUITE 102",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432323198",
            "telephone_number": "614-322-9210",
            "fax_number": "614-322-9214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 LAKE CLUB DR STE 102",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432323198",
            "telephone_number": "614-322-3210",
            "fax_number": "614-322-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING LIFE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-06",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A",
        "authorized_official_last_name": "MENSAH-ADDISON",
        "authorized_official_first_name": "EBENEZER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "NURSE",
        "authorized_official_telephone_number": "614-322-9210"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": "2126391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.