Provider Demographics
NPI:1649819111
Name:LIVEWELL CAREGIVER SERVICES
Entity type:Organization
Organization Name:LIVEWELL CAREGIVER SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:J
Authorized Official - Last Name:REZVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-379-6446
Mailing Address - Street 1:23995 NOVI RD
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-5439
Mailing Address - Country:US
Mailing Address - Phone:248-379-6446
Mailing Address - Fax:
Practice Address - Street 1:23995 NOVI RD
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-5439
Practice Address - Country:US
Practice Address - Phone:248-379-6446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No174200000XOther Service ProvidersMeals
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing CareGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty