Healthcare Provider Details

I. General information

NPI: 1497981724
Provider Name (Legal Business Name): LIVE TO ASSIST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2009
Last Update Date: 06/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1065 BEECHWOOD DR
HARVEY LA
70058-4330
US

IV. Provider business mailing address

1065 BEECHWOOD DR
HARVEY LA
70058-4330
US

V. Phone/Fax

Practice location:
  • Phone: 504-307-5920
  • Fax: 504-762-2309
Mailing address:
  • Phone: 504-307-5920
  • Fax: 504-762-2309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number35192740
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number35192740
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number35192740
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number35192740
License Number StateLA

VIII. Authorized Official

Name: MS. KAWANNA KAY PROUT
Title or Position: PRESIDENT
Credential:
Phone: 504-307-5920