Provider Demographics
NPI:1083322846
Name:LA LA'S FRUIT 4 KNOWLEDGE
Entity Type:Organization
Organization Name:LA LA'S FRUIT 4 KNOWLEDGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/BOARD MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LATISHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:234-275-7611
Mailing Address - Street 1:178 12TH ST
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:OH
Mailing Address - Zip Code:44405-1662
Mailing Address - Country:US
Mailing Address - Phone:234-275-7611
Mailing Address - Fax:330-953-2015
Practice Address - Street 1:178 12TH ST
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:OH
Practice Address - Zip Code:44405-1662
Practice Address - Country:US
Practice Address - Phone:234-275-7611
Practice Address - Fax:330-953-2015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health