Provider Demographics
NPI:1932508058
Name:A LOVING START
Entity Type:Organization
Organization Name:A LOVING START
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:305-215-8763
Mailing Address - Street 1:3001 W. HALLANDALE BEACH BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HALLANDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33009-5158
Mailing Address - Country:US
Mailing Address - Phone:305-215-8763
Mailing Address - Fax:305-397-2621
Practice Address - Street 1:3001 W. HALLANDALE BEACH BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:HALLANDALE
Practice Address - State:FL
Practice Address - Zip Code:33009-5158
Practice Address - Country:US
Practice Address - Phone:305-215-8763
Practice Address - Fax:305-397-2621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW119176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340158800Medicaid
FLY095YOtherFLORIDA BLUE