Provider Demographics
NPI:1538501275
Name:LOVE CENTER FOR HUMAN BEINGS
Entity Type:Organization
Organization Name:LOVE CENTER FOR HUMAN BEINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:WAINWRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-438-3086
Mailing Address - Street 1:100 E 23RD ST
Mailing Address - Street 2:2B
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-5807
Mailing Address - Country:US
Mailing Address - Phone:443-438-3086
Mailing Address - Fax:
Practice Address - Street 1:100 E 23RD ST
Practice Address - Street 2:2B
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-5807
Practice Address - Country:US
Practice Address - Phone:443-438-3086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health