Provider Demographics
NPI:1275214017
Name:LIVE LAUGH LOVE PC LLC
Entity Type:Organization
Organization Name:LIVE LAUGH LOVE PC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-575-5062
Mailing Address - Street 1:PO BOX 3611
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77805-3611
Mailing Address - Country:US
Mailing Address - Phone:979-575-5062
Mailing Address - Fax:936-727-5007
Practice Address - Street 1:1710 STONE RIDGE DR
Practice Address - Street 2:
Practice Address - City:NAVASOTA
Practice Address - State:TX
Practice Address - Zip Code:77868-3766
Practice Address - Country:US
Practice Address - Phone:979-575-5062
Practice Address - Fax:936-727-6007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No305R00000XManaged Care OrganizationsPreferred Provider Organization