Organization
LIVE.WELL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE TONKIN (OWNER)
(304) 612-8860
Entity
Organization
Contact information
Practice address
517 FAIRMONT AVE, FAIRMONT, WV 26554-5101
(304) 612-8860
Mailing address
1 HIDDEN TRL, FAIRMONT, WV 26554-8822
(304) 612-8860
(681) 214-1011
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2008
WV
Other
Enumeration date
11/22/2016
Last updated
11/22/2016
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