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Organization

LIVELYCARE

Active
Other names
Owner, Livelycare
Organization subpart
No

Provider details

NPI number
Authorized official
MS. HILDA ARDELLA LIVELY (OWNER)
(443) 683-3025
Entity
Organization

Contact information

Practice address
4401 FLOWERTON RD, BALTIMORE, MD 21229-1510
(443) 683-3025
Mailing address
4401 FLOWERTON RD, BALTIMORE, MD 21229-1510
(443) 683-3025

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
T082720220000017
MD
Enumeration date
04/15/2022
Last updated
09/19/2022
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