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LIVEWELL DIRECT SUPPORT LLC NPI 1972107043


NPI Information

NPI: 1972107043
Provider Name: LIVEWELL DIRECT SUPPORT, LLC

Other Name: MELISSA BOOTH, SOLE MEMBER

Classification: Day Training, Developmentally Disabled Services - 251C00000X
Entity Type: Organization
Address:
326 PATTON AVE
WINTERSVILLE, OH
ZIP 43953
Phone: (740) 232-9138
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LIVEWELL DIRECT SUPPORT, LLC is a day training developmentally disabled services in Wintersville, OH. The provider is these agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. LIVEWELL DIRECT SUPPORT, LLC NPI is 1972107043. The provider is registered as an organization entity type.
The provider Other Name Is Melissa Booth, Sole Member.

The provider's business location address is:

326 PATTON AVE
WINTERSVILLE, OH
ZIP 43953-848
Phone: (740) 232-9138

The provider's authorized official is Melissa Booth .
The authorized official title is Ceo and has the following contact phone number (740) 232-9138.

The enumeration date for this NPI number is 11/29/2020 and was last updated on 10/20/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthNo
2251X00000XSupports BrokerageNo
3253Z00000XIn Home Supportive CareNo
4261QA0600XClinic/CenterAdult Day CareNo
5343900000XNon-emergency Medical Transport (VAN)No
6347C00000XPrivate VehicleNo
7385HR2060XRespite CareRespite Care, Intellectual and/or Developmental DisabilitiesNo
8251C00000XDay Training, Developmentally Disabled ServicesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10058808MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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