Provider Demographics
NPI:1922694850
Name:WHOLE LATTE LOVE CAFE
Entity Type:Organization
Organization Name:WHOLE LATTE LOVE CAFE
Other - Org Name:WHOLE LATTE LOVE CAFE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER / EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUMBERT
Authorized Official - Suffix:
Authorized Official - Credentials:CRC, CESP
Authorized Official - Phone:330-323-8401
Mailing Address - Street 1:503 EASTBURY AVE NE
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-2136
Mailing Address - Country:US
Mailing Address - Phone:330-323-8401
Mailing Address - Fax:
Practice Address - Street 1:1308 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-4244
Practice Address - Country:US
Practice Address - Phone:330-323-8401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)