Provider Demographics
NPI:1558047100
Name:LIVE WELL HOME CARE LLC
Entity Type:Organization
Organization Name:LIVE WELL HOME CARE LLC
Other - Org Name:LIVE WELL HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIVE
Authorized Official - Middle Name:
Authorized Official - Last Name:WELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-247-6129
Mailing Address - Street 1:141 N ROADRUNNER PKWY STE 141
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-2000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:141 N ROADRUNNER PKWY STE 141
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-2000
Practice Address - Country:US
Practice Address - Phone:915-247-6129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIVE WELL HOME CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-27
Last Update Date:2023-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care