| NPI | 1033986575 |
|---|---|
| Former Legal Business Name | LIVING FULLY, LLC |
| Entity Type | Organization |
| Authorized Contact | MIGUELINA DALTON Owner 845-304-5189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-12-05 |
| Last Update Date | 2023-12-05 |