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General NPI Number Information
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NPI Number | 1003774787
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Entity Type | Organization
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Legal Business Name | LIVING OUR LIVES (LOL) COMMUNITY LIVING LLC
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 322 MILLEDGEVILLE HWY
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City | GORDON
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State | GA
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Zip | 31031-4177
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Country | US
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Telephone | 478-457-6226
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Fax | 478-628-4054
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Provider Business Mailing Address
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Address Line | 322 MILLEDGEVILLE HWY
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City | GORDON
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State | GA
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Zip | 31031-4177
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Country | US
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Telephone | 478-457-6226
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Fax | 478-628-4054
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Authorized Official
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Title or Position | OWNER/CEO
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Name | PAMELA W. BREZIAL REAVES
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Credential | CNA
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Telephone | 478-457-6226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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