Organization
LIVELY VIRTUAL CARE ORGANIZATION PC
Active
Other names
Lively Virtual Care Organization PC
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA KOCSIS MHA (CEO)
(916) 622-3609
Entity
Organization
Contact information
Practice address
108 BEN EZRA AVE, ROSEVILLE, CA 95678-2702
(916) 235-8617
(916) 846-9463
Mailing address
PO BOX 604, ROSEVILLE, CA 95661-0604
(916) 622-3609
(916) 333-3634
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
251E00000X
Home Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261Q00000X
Clinic/Center
—
—
305S00000X
Point of Service
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
07/07/2023
Last updated
02/05/2024
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