Healthcare Provider Details

I. General information

NPI: 1417865593
Provider Name (Legal Business Name): LIVING WELL CARE & SUPPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3151 S VAUGHN WAY STE 660
AURORA CO
80014-3514
US

IV. Provider business mailing address

3151 S VAUGHN WAY STE 660
AURORA CO
80014-3514
US

V. Phone/Fax

Practice location:
  • Phone: 720-961-3547
  • Fax:
Mailing address:
  • Phone: 720-961-3547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: SYLVERLINE AGOMOH
Title or Position: OWNER
Credential: OT
Phone: 720-961-3547