Provider Demographics
NPI:1609344803
Name:AEM LOVE LLC
Entity Type:Organization
Organization Name:AEM LOVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAYSUNN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSES-WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-402-9765
Mailing Address - Street 1:555 SCHAEFER AVE
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-2729
Mailing Address - Country:US
Mailing Address - Phone:757-402-9765
Mailing Address - Fax:
Practice Address - Street 1:124 GILLIS RD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23702
Practice Address - Country:US
Practice Address - Phone:757-956-1017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities