Living Well Enterprises, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL-092-175 Issued in NC

Legal business name

LIVING WELL ENTERPRISES, LLC

Doing business as

Living Well Family Care Home

Practice address

5932 Sandy Forks Rd
Raleigh, NC 27609-3814

Phone

(919) 255-2404

NPI assigned

May 10, 2012

Organization subpart

No

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

Authorized official

Name

Jacqueline Thompson

Title

Owner/Administrator

Phone

(919) 255-2404

Specialties & licenses 1

Addresses

Other names 1

• Living Well Family Care Home Doing business as

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

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336608000000",
    "number": "1508125642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5616 OLD FORGE CIR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094032",
            "telephone_number": "919-255-2404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5932 SANDY FORKS RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276093814",
            "telephone_number": "919-255-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-10",
        "last_updated": "2012-05-10",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "919-255-2404"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL-092-175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Living Well Family Care Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Care Home Facility in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.