Provider Demographics
NPI:1598905812
Name:AAA LOVELY CARE LLC
Entity Type:Organization
Organization Name:AAA LOVELY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:K
Authorized Official - Last Name:HARWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-592-0920
Mailing Address - Street 1:607 UNIVERSITY BLVD W
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-4626
Mailing Address - Country:US
Mailing Address - Phone:301-592-0920
Mailing Address - Fax:301-592-0921
Practice Address - Street 1:607 UNIVERSITY BLVD W
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-4626
Practice Address - Country:US
Practice Address - Phone:301-592-0920
Practice Address - Fax:301-592-0921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization