Healthcare Provider Details

I. General information

NPI: 1356272967
Provider Name (Legal Business Name): LIVE YOUR DREAMS EVERYDAY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BUFFALO AVE NW STE 2201
CONCORD NC
28025-4007
US

IV. Provider business mailing address

406 ELK ST APT R95
GREENEVILLE TN
37745-4632
US

V. Phone/Fax

Practice location:
  • Phone: 704-450-0215
  • Fax:
Mailing address:
  • Phone: 704-450-0215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID ALEXANDER LYDE
Title or Position: CEO
Credential: CADC-R
Phone: 704-450-0215