| Live Your Wellness Llc | |
|
3240 S Corona St Englewood CO 80113-2816 | |
| (303) 622-5698 | |
| Not Available |
| Full Name | Live Your Wellness Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3240 S Corona St, Englewood, Colorado |
| Authorized Official Name and Position | Michael R Dell (OWNER) |
| Authorized Official Contact | 3036225698 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Your Wellness Llc Po Box 100856 Denver CO 80250-0856 Ph: (303) 622-5698 | Live Your Wellness Llc 3240 S Corona St Englewood CO 80113-2816 Ph: (303) 622-5698 |
| NPI Number | 1821465121 |
|---|---|
| Provider Enumeration Date | 08/22/2015 |
| Last Update Date | 04/19/2021 |
| Certification Date | 04/19/2021 |
| Medicare PECOS PAC ID | 7315246642 |
|---|---|
| Medicare Enrollment ID | O20160509000492 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821465121 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 00992544 (Colorado) | Primary |
| Provider Name | Michael R Dell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629174438 PECOS PAC ID: 0345288148 Enrollment ID: I20141015001501 |
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