Provider Demographics
NPI:1689930562
Name:PAINTED LOVE, INC.
Entity Type:Organization
Organization Name:PAINTED LOVE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:WINKLE-GORSLINE
Authorized Official - Suffix:
Authorized Official - Credentials:LREB
Authorized Official - Phone:845-430-5473
Mailing Address - Street 1:70 LINDSLEY AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-3316
Mailing Address - Country:US
Mailing Address - Phone:845-430-5473
Mailing Address - Fax:
Practice Address - Street 1:70 LINDSLEY AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-3316
Practice Address - Country:US
Practice Address - Phone:845-430-5473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-05
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY35WI0999859251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health