Provider Demographics
NPI:1659900660
Name:LOVE LIGHT AND HEALING, LLC.
Entity Type:Organization
Organization Name:LOVE LIGHT AND HEALING, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ ACU-DETOX SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BARRETO
Authorized Official - Suffix:
Authorized Official - Credentials:ADS
Authorized Official - Phone:480-465-8402
Mailing Address - Street 1:3303 E BASELINE RD STE 109
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2739
Mailing Address - Country:US
Mailing Address - Phone:480-465-8402
Mailing Address - Fax:
Practice Address - Street 1:3303 E BASELINE RD STE 109
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2739
Practice Address - Country:US
Practice Address - Phone:480-465-8402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty