Provider Demographics
NPI:1578214656
Name:LIVESWORTH HEALTHCARE LLC
Entity Type:Organization
Organization Name:LIVESWORTH HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OSAYI
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:AIGBEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-614-2854
Mailing Address - Street 1:2430 SHELLY LANG CT
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2089
Mailing Address - Country:US
Mailing Address - Phone:832-614-2854
Mailing Address - Fax:
Practice Address - Street 1:2430 SHELLY LANG CT
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-2089
Practice Address - Country:US
Practice Address - Phone:832-614-2854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty