MEDICARE: LIVE WELL HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1104657378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVE WELL HOME CARE LLC

Provider Business Mailing Address
First Line	:	5236 FILLMORE AVE
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22311-1202
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5236 FILLMORE AVE
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22311-1202
Country	:	US
Telephone Number	:	571-493-3016
Fax Number	:

Authorized Official
Title or Position	:	OWNER, PRESIDENT
Name	:	WALEED SYED
Credential	:
Telephone Number	:	571-493-3016

Provider Enumeration Date	:	08/09/2024
Last Update Date	:	08/09/2024

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Directions to “LIVE WELL HOME CARE LLC ” Practice Location

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