# MINE LIVING LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144075466
- **Authorized official:** ANTHONY QUALLS (OWNER)
- **Authorized official phone:** (614) 456-9952

## Contact information

- **Practice address:** 6100 CHANNINGWAY BLVD STE 406, COLUMBUS, OH 43232-2910
- **Practice address phone:** (614) 456-9952
- **Mailing address:** 869 E 13TH AVE, COLUMBUS, OH 43211-2727
- **Mailing address phone:** (614) 456-9952

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 04/19/2024
- **Last updated:** 04/19/2024