Provider Demographics
NPI:1609454164
Name:FOUNDATION OF LUV INC.
Entity Type:Organization
Organization Name:FOUNDATION OF LUV INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:LEROY
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-804-4731
Mailing Address - Street 1:8203 HARFORD RD STE C
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-5888
Mailing Address - Country:US
Mailing Address - Phone:443-804-4731
Mailing Address - Fax:
Practice Address - Street 1:8203 HARFORD RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-5888
Practice Address - Country:US
Practice Address - Phone:443-804-4731
Practice Address - Fax:443-835-2710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)