Provider Demographics
NPI:1124493275
Name:LIVEWELL CARE LLC
Entity type:Organization
Organization Name:LIVEWELL CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER AND CARE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-320-1310
Mailing Address - Street 1:3980 LIMELIGHT AVE
Mailing Address - Street 2:UNIT H
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-8011
Mailing Address - Country:US
Mailing Address - Phone:720-287-1685
Mailing Address - Fax:720-458-0589
Practice Address - Street 1:3990 LIMELIGHT AVE UNIT E
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-8036
Practice Address - Country:US
Practice Address - Phone:720-287-1685
Practice Address - Fax:720-458-0589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-01
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04N650253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care