Provider Demographics
NPI:1578980819
Name:LOVE HEALTH CARE CENTER
Entity Type:Organization
Organization Name:LOVE HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEUX
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:678-527-9660
Mailing Address - Street 1:1542 PONY RANCH CIR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-0348
Mailing Address - Country:US
Mailing Address - Phone:678-527-9660
Mailing Address - Fax:
Practice Address - Street 1:1542 PONY RANCH CIR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-0348
Practice Address - Country:US
Practice Address - Phone:678-527-9660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health