Provider Demographics
NPI:1881991180
Name:LIVE LIFE SERVICES LLC
Entity type:Organization
Organization Name:LIVE LIFE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:616-915-3701
Mailing Address - Street 1:4150 225TH AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:REED CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49677-7910
Mailing Address - Country:US
Mailing Address - Phone:616-915-3701
Mailing Address - Fax:
Practice Address - Street 1:4150 225TH AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:REED CITY
Practice Address - State:MI
Practice Address - Zip Code:49677-7910
Practice Address - Country:US
Practice Address - Phone:616-915-3701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment