Provider Demographics
NPI:1043704471
Name:LOVE IS PATIENCE HEALTH & WELLNESS
Entity Type:Organization
Organization Name:LOVE IS PATIENCE HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COMMORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LYLES - MAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-422-1650
Mailing Address - Street 1:1050 WHITNEY RANCH DR APT 1925
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-2547
Mailing Address - Country:US
Mailing Address - Phone:213-422-1650
Mailing Address - Fax:
Practice Address - Street 1:1915 SIMMONS ST APT 2130
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-1560
Practice Address - Country:US
Practice Address - Phone:213-422-1650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20181437177251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health