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Organization
LIVE LOVE LIFE, INC
Active
Organization
LIVE LOVE LIFE, INC
Active
Parent organization
LIVE LOVE LIFE, INC
Other names
Live Love Life, Jacksonville
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIVE LOVE LIFE, INC
Authorized official
MR. MARK A. WALCZYK (CHIEF OPERATING OFFICER)
(585) 233-0105
Entity
Organization
Contact information
Practice address
1951 BOULEVARD, JACKSONVILLE, FL 32206-3527
(904) 640-7954
(386) 272-7938
Mailing address
1700 RIDGEWOOD AVE, SUITE I, HOLLY HILL, FL 32117-1782
(585) 233-0105
(386) 492-3661
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NULL
251V00000X
Voluntary or Charitable Agency
—
NULL
261QC1500X
Community Health Clinic/Center
Primary
—
NULL
261QP0905X
State or Local Public Health Clinic/Center
—
NULL
Other
Enumeration date
11/13/2020
Last updated
04/25/2024
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