Provider Demographics
NPI:1609319979
Name:LIVE HEALTHCARE GROUP LLC
Entity type:Organization
Organization Name:LIVE HEALTHCARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-924-5690
Mailing Address - Street 1:2437 QUANTUM BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8612
Mailing Address - Country:US
Mailing Address - Phone:866-924-5690
Mailing Address - Fax:888-726-8451
Practice Address - Street 1:2437 QUANTUM BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8612
Practice Address - Country:US
Practice Address - Phone:866-924-5690
Practice Address - Fax:888-726-8451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-18
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty