Provider Demographics
NPI:1639875842
Name:LIVE AND LOVE COMPANION CARE LLC
Entity Type:Organization
Organization Name:LIVE AND LOVE COMPANION CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:T
Authorized Official - Last Name:SPEARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-745-9012
Mailing Address - Street 1:3236 FORUM BLVD # 1192
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-5582
Mailing Address - Country:US
Mailing Address - Phone:239-745-9012
Mailing Address - Fax:
Practice Address - Street 1:1909 VENICE AVE N
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-5249
Practice Address - Country:US
Practice Address - Phone:239-745-9012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No251E00000XAgenciesHome Health