Organization
LIVE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE L. BOOTZ (BUSINESS MANAGER)
(605) 374-3742
Entity
Organization
Contact information
Practice address
407 2ND AVE W, LEMMON, SD 57638-1405
(605) 374-3742
(605) 374-3238
Mailing address
407 2ND AVE W, P.O. BOX 59, LEMMON, SD 57638-1405
(605) 374-3742
(605) 374-3238
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
0180090
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0180090
—
SD
Enumeration date
01/24/2007
Last updated
08/22/2020
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