Provider Demographics
NPI:1467046557
Name:LOVELIGHT PSYCHIATRIC CARE
Entity Type:Organization
Organization Name:LOVELIGHT PSYCHIATRIC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZA
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:MARRONI
Authorized Official - Suffix:
Authorized Official - Credentials:PMHMP
Authorized Official - Phone:734-546-8133
Mailing Address - Street 1:2846 GRAND VIEW CT
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-6885
Mailing Address - Country:US
Mailing Address - Phone:734-546-8133
Mailing Address - Fax:
Practice Address - Street 1:2846 GRAND VIEW CT
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-6885
Practice Address - Country:US
Practice Address - Phone:734-546-8133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty