Provider Demographics
NPI:1013178748
Name:UNCONDITIONAL LOVE INCORPORATED
Entity Type:Organization
Organization Name:UNCONDITIONAL LOVE INCORPORATED
Other - Org Name:COMPREHENSIVE HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIDITA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-259-8928
Mailing Address - Street 1:1495 N HARBOR CITY BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-6572
Mailing Address - Country:US
Mailing Address - Phone:321-253-0846
Mailing Address - Fax:321-253-1004
Practice Address - Street 1:1509 N HARBOR CITY BLVD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-6572
Practice Address - Country:US
Practice Address - Phone:321-253-0846
Practice Address - Fax:321-253-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL034139800Medicaid