# LIVE LOVE LIFE, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LIVE LOVE LIFE, INC
- **Other names:** Live Love Life, Jacksonville
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1265034227
- **Legal business name:** LIVE LOVE LIFE, INC
- **Authorized official:** MR. MARK A. WALCZYK (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (585) 233-0105

## Contact information

- **Practice address:** 1951 BOULEVARD, JACKSONVILLE, FL 32206-3527
- **Practice address phone:** (904) 640-7954
- **Practice address fax:** (386) 272-7938
- **Mailing address:** 1700 RIDGEWOOD AVE, SUITE I, HOLLY HILL, FL 32117-1782
- **Mailing address phone:** (585) 233-0105
- **Mailing address fax:** (386) 492-3661

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251V00000X | Voluntary or Charitable Agency | — | NULL | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |
| 261QP0905X | State or Local Public Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 11/13/2020
- **Last updated:** 04/25/2024