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Organization

LIVEWELL DIRECT SUPPORT, LLC

Active
Other names
Melissa Booth, Sole Member
Organization subpart
No

Provider details

NPI number
Authorized official
MELISSA BOOTH (CEO)
(740) 232-9138
Entity
Organization

Contact information

Practice address
326 PATTON AVE, WINTERSVILLE, OH 43953-3848
(740) 232-9138
Mailing address
326 PATTON AVE, WINTERSVILLE, OH 43953-3848
(740) 232-9138

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
251S00000X
Community/Behavioral Health Agency
251X00000X
Supports Brokerage Agency
253Z00000X
In Home Supportive Care Agency
261QA0600X
Adult Day Care Clinic/Center
343900000X
Non-emergency Medical Transport (VAN)
347C00000X
Private Vehicle
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0058808
OH
Enumeration date
11/29/2020
Last updated
10/20/2022
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