Provider Demographics
NPI:1093367328
Name:LOVE SERVICES LLC
Entity Type:Organization
Organization Name:LOVE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OLUFEMI
Authorized Official - Middle Name:A
Authorized Official - Last Name:OMODARA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:623-521-5935
Mailing Address - Street 1:7227 S CENTRAL AVE STE 1080
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-5457
Mailing Address - Country:US
Mailing Address - Phone:623-521-5935
Mailing Address - Fax:602-441-4838
Practice Address - Street 1:7227 S CENTRAL AVE STE 1080
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-5457
Practice Address - Country:US
Practice Address - Phone:623-521-5935
Practice Address - Fax:602-441-4838
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOVE BEHAVIOURAL SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services