Provider Demographics
NPI:1699376160
Name:LOVE, BREANNA OLIVIA ZION ENTERPRISE,LLC(LBOZ):
Entity Type:Organization
Organization Name:LOVE, BREANNA OLIVIA ZION ENTERPRISE,LLC(LBOZ):
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVE-COSBY
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED SOCIAL WORK
Authorized Official - Phone:614-403-7089
Mailing Address - Street 1:1985 W HENDERSON ROAD #2223
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220
Mailing Address - Country:US
Mailing Address - Phone:614-403-7089
Mailing Address - Fax:
Practice Address - Street 1:9802 N IVY PARK DR
Practice Address - Street 2:
Practice Address - City:FORTSON
Practice Address - State:GA
Practice Address - Zip Code:31808-7130
Practice Address - Country:US
Practice Address - Phone:614-403-7089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health