Healthcare Provider Details

I. General information

NPI: 1427961879
Provider Name (Legal Business Name): LIVE WELL HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 N KROHN PL
SIOUX FALLS SD
57103-1800
US

IV. Provider business mailing address

102 N KROHN PL
SIOUX FALLS SD
57103-1800
US

V. Phone/Fax

Practice location:
  • Phone: 407-485-4839
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: RUTURWA WILLY MUTIMA
Title or Position: PRESIDENT
Credential:
Phone: 407-485-4839