Organization
LIVING WELL ENTERPRISES, LLC
Active
Other names
Living Well Family Care Home
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE THOMPSON (OWNER/ADMINISTRATOR)
(919) 255-2404
Entity
Organization
Contact information
Practice address
5932 SANDY FORKS RD, RALEIGH, NC 27609-3814
(919) 255-2404
Mailing address
5616 OLD FORGE CIR, RALEIGH, NC 27609-4032
(919) 255-2404
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL-092-175
NC
Other
Enumeration date
05/10/2012
Last updated
05/10/2012
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