Provider Demographics
NPI:1417362799
Name:A LOVELAND VENTURE, LLC.
Entity Type:Organization
Organization Name:A LOVELAND VENTURE, LLC.
Other - Org Name:THE PHOENIX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-435-5129
Mailing Address - Street 1:5856 S LOWELL BLVD # 32-403
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-7915
Mailing Address - Country:US
Mailing Address - Phone:636-226-4159
Mailing Address - Fax:314-552-7075
Practice Address - Street 1:5856 S LOWELL BLVD # 32-403
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-7915
Practice Address - Country:US
Practice Address - Phone:636-226-4159
Practice Address - Fax:314-552-7075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-25
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty