Provider Demographics
NPI:1275057291
Name:LOVE TO LIFE
Entity Type:Organization
Organization Name:LOVE TO LIFE
Other - Org Name:LOVE TO LIFE ADULT DAYCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BEULAH
Authorized Official - Middle Name:B
Authorized Official - Last Name:BRANDON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:314-643-5369
Mailing Address - Street 1:8229 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63147-2323
Mailing Address - Country:US
Mailing Address - Phone:314-643-5369
Mailing Address - Fax:
Practice Address - Street 1:8229 N BROADWAY
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63147-2323
Practice Address - Country:US
Practice Address - Phone:314-643-5369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOVE TO LIFE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home