Provider Demographics
NPI:1538939475
Name:ENRICHED LIVING CARE LLC
Entity type:Organization
Organization Name:ENRICHED LIVING CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:OPOKU AGYEMANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-206-6939
Mailing Address - Street 1:11780 PASSAGE WAY APT 165
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-4248
Mailing Address - Country:US
Mailing Address - Phone:513-206-6939
Mailing Address - Fax:
Practice Address - Street 1:11780 PASSAGE WAY APT 165
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-4248
Practice Address - Country:US
Practice Address - Phone:513-206-6939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty