Provider Demographics
NPI:1619581170
Name:UNCONDITIONAL LOVE ADULT FAMILY HOMES
Entity Type:Organization
Organization Name:UNCONDITIONAL LOVE ADULT FAMILY HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATONDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-768-7015
Mailing Address - Street 1:3906 WATERPROOF
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-4404
Mailing Address - Country:US
Mailing Address - Phone:254-768-7015
Mailing Address - Fax:
Practice Address - Street 1:3906 WATERPROOF
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-4404
Practice Address - Country:US
Practice Address - Phone:254-768-7015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home