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General NPI Number Information
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NPI Number | 1144034992
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Entity Type | Organization
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Legal Business Name | LIVE LIFE IN FULL BLOOM TOO LLC
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 7277 HANOVER GREEN DR STE A2
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City | MECHANICSVILLE
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State | VA
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Zip | 23111-1764
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Country | US
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Telephone | 804-933-8357
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Fax |
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Provider Business Mailing Address
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Address Line | 2615 OAK HILL RD
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City | PETERSBURG
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State | VA
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Zip | 23805-2425
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Country | US
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Telephone | 804-933-8357
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIELLE JANES
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Credential | QMHP-A, CSAC-A
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Telephone | 804-933-8357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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