MEDICARE: LIVEABILITY 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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1770297111
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVEABILITY LLC

Provider Business Mailing Address
First Line	:	9 TAYLOR LOOP
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87508-4509
Country	:	US
Telephone Number	:	505-519-6932
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 TAYLOR LOOP
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87508-4509
Country	:	US
Telephone Number	:	505-519-6932
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMANDA MACEWEN
Credential	:	MOTR/L
Telephone Number	:	505-519-6932

Provider Enumeration Date	:	01/10/2023
Last Update Date	:	04/22/2023

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Directions to “LIVEABILITY LLC ” Practice Location

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