Provider Demographics
NPI:1851772271
Name:LOVELIFE FAMILY SERVICES L.L.C
Entity Type:Organization
Organization Name:LOVELIFE FAMILY SERVICES L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CLEVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:FUNCHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-754-3484
Mailing Address - Street 1:6330 MCLEOD DR STE 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-4431
Mailing Address - Country:US
Mailing Address - Phone:702-754-3484
Mailing Address - Fax:702-629-7952
Practice Address - Street 1:6330 MCLEOD DR STE 3
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-4431
Practice Address - Country:US
Practice Address - Phone:702-754-3484
Practice Address - Fax:702-629-7952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV08Medicare PIN