Provider Demographics
NPI:1326819178
Name:FIRST LOVE BEHAVIORAL CARE LLC
Entity Type:Organization
Organization Name:FIRST LOVE BEHAVIORAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GUADALUPE
Authorized Official - Middle Name:E
Authorized Official - Last Name:FIERRO VALDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-501-1389
Mailing Address - Street 1:817 S 165TH DR
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-4590
Mailing Address - Country:US
Mailing Address - Phone:602-501-1389
Mailing Address - Fax:
Practice Address - Street 1:817 S 165TH DR
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-4590
Practice Address - Country:US
Practice Address - Phone:602-501-1389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No251S00000XAgenciesCommunity/Behavioral Health