Provider Demographics
NPI:1265674899
Name:LIVINGWELL HOME HEALTHCARE SERVICES OF VA, LLC
Entity Type:Organization
Organization Name:LIVINGWELL HOME HEALTHCARE SERVICES OF VA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-489-4191
Mailing Address - Street 1:PO BOX 6591
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-0591
Mailing Address - Country:US
Mailing Address - Phone:866-489-4191
Mailing Address - Fax:866-496-3091
Practice Address - Street 1:6802 PARAGON PL
Practice Address - Street 2:SUITE 410
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1644
Practice Address - Country:US
Practice Address - Phone:866-489-4191
Practice Address - Fax:866-896-3091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-27
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care