Healthcare Provider Details

I. General information

NPI: 1487570008
Provider Name (Legal Business Name): THE L.I.V.E. PROGRAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3708 HEWITT ST
GREENSBORO NC
27407-2224
US

IV. Provider business mailing address

41 LEDGER STONE LN
GREENSBORO NC
27407-4199
US

V. Phone/Fax

Practice location:
  • Phone: 336-303-0314
  • Fax:
Mailing address:
  • Phone: 336-303-0314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: NICOLE ARCHIE
Title or Position: FOUNDER
Credential:
Phone: 336-303-0314