MEDICARE: LIVE SAVER'S 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	:	1972290278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIVE SAVER'S LLC

Provider Business Mailing Address
First Line	:	601 BELLA WAY
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23236-3274
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	334 RIDGE RD
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-2426
Country	:	US
Telephone Number	:	804-539-6799
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SEAN JONES
Credential	:
Telephone Number	:	804-539-6799

Provider Enumeration Date	:	04/18/2023
Last Update Date	:	04/18/2023

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Directions to “LIVE SAVER'S LLC ” Practice Location

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