Provider Demographics
NPI:1184367716
Name:EXCEPTIONAL LIVING LLC
Entity type:Organization
Organization Name:EXCEPTIONAL LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAAD
Authorized Official - Middle Name:
Authorized Official - Last Name:WAQAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-437-6885
Mailing Address - Street 1:52 GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-4250
Mailing Address - Country:US
Mailing Address - Phone:973-437-6885
Mailing Address - Fax:
Practice Address - Street 1:52 GARDEN ST
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-4250
Practice Address - Country:US
Practice Address - Phone:973-437-6885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXCEPTIONAL ENTERPRISES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-20
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization