Provider Demographics
NPI:1124807193
Name:LIVE WELL HOME CARE, LLC
Entity type:Organization
Organization Name:LIVE WELL HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGHTOWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-630-9366
Mailing Address - Street 1:4135 LAYNEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-2222
Mailing Address - Country:US
Mailing Address - Phone:770-630-9366
Mailing Address - Fax:
Practice Address - Street 1:4135 LAYNEWOOD CIR
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-2222
Practice Address - Country:US
Practice Address - Phone:770-630-9366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty