# LIVE LOVE LIFE, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Live Love Life, Daytona, Live Love Life, Jacksonville, Live Love Life, DeLand, Live Love Life, Ormond, Live Love Life Orlando, Live Love Life, Universal Orlando, Live Love Life, Southside Jacksonville, LIVE LOVE LIFE, HOLLY HILL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437773280
- **Authorized official:** MR. MARK A. WALCZYK (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (585) 233-0105

## Contact information

- **Practice address:** 1702 RIDGEWOOD AVE STE J, HOLLY HILL, FL 32117-1783
- **Practice address phone:** (904) 458-5444
- **Practice address fax:** (386) 760-7649
- **Mailing address:** 1700 RIDGEWOOD AVE STE I, HOLLY HILL, FL 32117-1782
- **Mailing address phone:** (904) 458-5444
- **Mailing address fax:** (386) 760-7649

## 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:** 06/07/2020
- **Last updated:** 04/25/2024