Provider Demographics
NPI:1649716804
Name:LIVING AND LEARNING ENRICHMENT CENTER
Entity type:Organization
Organization Name:LIVING AND LEARNING ENRICHMENT CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & CEO
Authorized Official - Prefix:
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:VARTANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-308-3592
Mailing Address - Street 1:801 GRISWOLD ST
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-1673
Mailing Address - Country:US
Mailing Address - Phone:248-308-3592
Mailing Address - Fax:248-773-8686
Practice Address - Street 1:315 GRISWOLD ST
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-1615
Practice Address - Country:US
Practice Address - Phone:248-308-3592
Practice Address - Fax:248-773-8686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child