Organization
LIVE-TO-HYDRATE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESTINY BURROUGHS RN (OWNER)
(910) 551-3665
Entity
Organization
Contact information
Practice address
308 HAY ST STE B, FAYETTEVILLE, NC 28301-5574
(910) 518-8227
Mailing address
PO BOX 20004, FAYETTEVILLE, NC 28301-6551
(910) 518-8227
Taxonomy
Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
Primary
—
—
Other
Enumeration date
05/05/2022
Last updated
05/05/2022
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