Provider Demographics
NPI:1982233920
Name:LIVECARE, INC.
Entity Type:Organization
Organization Name:LIVECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEGAL COUNSEL
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-953-9070
Mailing Address - Street 1:PO BOX 1832
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-1832
Mailing Address - Country:US
Mailing Address - Phone:801-953-9070
Mailing Address - Fax:801-365-9731
Practice Address - Street 1:1830 PROSPECTOR AVENUE
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84060
Practice Address - Country:US
Practice Address - Phone:801-953-9070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-02
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care