Healthcare Provider Details

I. General information

NPI: 1982233920
Provider Name (Legal Business Name): LIVECARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2020
Last Update Date: 04/10/2020
Certification Date: 04/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 PROSPECTOR AVENUE
PARK CITY UT
84060
US

IV. Provider business mailing address

PO BOX 1832
DRAPER UT
84020-1832
US

V. Phone/Fax

Practice location:
  • Phone: 801-953-9070
  • Fax:
Mailing address:
  • Phone: 801-953-9070
  • Fax: 801-365-9731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN BRANNELLY
Title or Position: LEGAL COUNSEL
Credential:
Phone: 801-953-9070