Provider Demographics
NPI:1871186692
Name:PRIORITY LOVE GROUP HOMES
Entity Type:Organization
Organization Name:PRIORITY LOVE GROUP HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DARCELL
Authorized Official - Middle Name:LANIER
Authorized Official - Last Name:WHITAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-312-6883
Mailing Address - Street 1:1610 GLENDALE ST
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-6922
Mailing Address - Country:US
Mailing Address - Phone:804-312-6883
Mailing Address - Fax:
Practice Address - Street 1:1610 GLENDALE ST
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-6922
Practice Address - Country:US
Practice Address - Phone:804-312-6883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities