Provider Demographics
NPI:1932774957
Name:LIVEWELL PSYCHIATRY LLC
Entity Type:Organization
Organization Name:LIVEWELL PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAFER
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:970-549-0757
Mailing Address - Street 1:2764 COMPASS DR STE 229
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8722
Mailing Address - Country:US
Mailing Address - Phone:970-549-0757
Mailing Address - Fax:970-433-7624
Practice Address - Street 1:2764 COMPASS DR STE 229
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-8722
Practice Address - Country:US
Practice Address - Phone:970-549-0757
Practice Address - Fax:970-433-7624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-21
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty