MEDICARE: LIVEWELL COMMUNITY SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1629908546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVEWELL COMMUNITY SERVICES LLC

Provider Business Mailing Address
First Line	:	24700 AURORA RD STE 3A
Second Line	:
City	:	BEDFORD HTS
State	:	OH
Zip	:	44146-1786
Country	:	US
Telephone Number	:	216-868-6545
Fax Number	:

Provider Business Practice Location Address
First Line	:	24700 AURORA RD STE 3A
Second Line	:
City	:	BEDFORD HTS
State	:	OH
Zip	:	44146-1786
Country	:	US
Telephone Number	:	216-868-6545
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TASHAWNNA M MURRAY
Credential	:
Telephone Number	:	216-868-6545

Provider Enumeration Date	:	05/21/2026
Last Update Date	:	05/21/2026

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