Provider Demographics
NPI:1548006216
Name:FOURTH DIMENSION LIVING,LLC
Entity type:Organization
Organization Name:FOURTH DIMENSION LIVING,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:AMADOR
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PEER COUNSELOR
Authorized Official - Phone:509-713-9462
Mailing Address - Street 1:3593 W 11TH PL
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-2047
Mailing Address - Country:US
Mailing Address - Phone:509-713-9464
Mailing Address - Fax:
Practice Address - Street 1:1511 MAHAN AVE
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-2967
Practice Address - Country:US
Practice Address - Phone:509-713-9462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-02
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health