Living Hope Residence, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

LIVING HOPE RESIDENCE, LLC

Practice address

6387 Bimini Dr
Forest Park, GA 30297-3447

Phone

(401) 241-7859

NPI assigned

Jul 27, 2017

Organization subpart

No

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

Authorized official

Name

Nelson Tenebe

Title

Owner

Phone

(401) 241-7859

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501113600000",
    "number": "1972027316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 PLUMB BRANCH CT",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302537585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6387 BIMINI DR",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302973447",
            "telephone_number": "401-241-7859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING HOPE RESIDENCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-27",
        "last_updated": "2017-07-27",
        "status": "A",
        "authorized_official_last_name": "TENEBE",
        "authorized_official_first_name": "NELSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-241-7859"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2017; 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.