Provider Demographics
NPI:1679012165
Name:LIBERATING LOVE CO.
Entity Type:Organization
Organization Name:LIBERATING LOVE CO.
Other - Org Name:LIBERATING LOVE HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-608-1950
Mailing Address - Street 1:8201 PETERS RD
Mailing Address - Street 2:SUITE 1000-82
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3265
Mailing Address - Country:US
Mailing Address - Phone:888-608-1950
Mailing Address - Fax:754-800-3902
Practice Address - Street 1:8201 PETERS RD
Practice Address - Street 2:SUITE 1000-82
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3265
Practice Address - Country:US
Practice Address - Phone:888-608-1950
Practice Address - Fax:754-800-3902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017863300Medicaid