Healthcare Provider Details

I. General information

NPI: 1760600811
Provider Name (Legal Business Name): LIVE FREE HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 PATRIOT LN
NEW HAMPTON NH
03256-4543
US

IV. Provider business mailing address

10 PATRIOT LN
NEW HAMPTON NH
03256-4543
US

V. Phone/Fax

Practice location:
  • Phone: 603-346-4214
  • Fax:
Mailing address:
  • Phone: 603-346-4214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number03163
License Number StateNH

VIII. Authorized Official

Name: JASON HARVEY
Title or Position: CO-ADMINISTRATOR
Credential:
Phone: 603-346-4214