Provider Demographics
NPI:1134847007
Name:LIVEWELL SERVICES, LLC
Entity type:Organization
Organization Name:LIVEWELL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ELIEZER
Authorized Official - Middle Name:MOREIRA
Authorized Official - Last Name:DA SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-658-6012
Mailing Address - Street 1:320 SHADOWWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:OVILLA
Mailing Address - State:TX
Mailing Address - Zip Code:75154-1424
Mailing Address - Country:US
Mailing Address - Phone:817-658-6012
Mailing Address - Fax:
Practice Address - Street 1:320 SHADOWWOOD TRL
Practice Address - Street 2:
Practice Address - City:OVILLA
Practice Address - State:TX
Practice Address - Zip Code:75154-1424
Practice Address - Country:US
Practice Address - Phone:817-658-6012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care