Provider Demographics
NPI:1588245740
Name:LIVE WELL HEALTH CARE, INC.
Entity type:Organization
Organization Name:LIVE WELL HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:LYUBA
Authorized Official - Middle Name:
Authorized Official - Last Name:NILUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-670-0608
Mailing Address - Street 1:4201 SHELTER CREEK LN
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-3815
Mailing Address - Country:US
Mailing Address - Phone:415-670-0608
Mailing Address - Fax:
Practice Address - Street 1:160 6TH ST STE B
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2828
Practice Address - Country:US
Practice Address - Phone:650-218-0032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient