Provider Demographics
NPI:1407572092
Name:LOVE MINISTRIES INTERNATIONAL CHURCH OF GOD
Entity Type:Organization
Organization Name:LOVE MINISTRIES INTERNATIONAL CHURCH OF GOD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:JERRIDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-262-4566
Mailing Address - Street 1:10700 TOWN CITY CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3600 S STATE ROAD 7 STE 223
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-7206
Practice Address - Country:US
Practice Address - Phone:507-262-4566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty