| NPI | 1164731873 |
|---|---|
| Doing Business As | LIVE LONG WELLCARE |
| Entity Type | Organization |
| Authorized Contact | DONALD O THOMPSON Manager 704-246-1616 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251E00000X Home Health (Licence: SC HHA-0205) |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2010-09-29 |