Provider Demographics
NPI:1942947981
Name:LEV WITH LOVE
Entity Type:Organization
Organization Name:LEV WITH LOVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHALOM
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-910-3713
Mailing Address - Street 1:111 PARK PL
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1958
Mailing Address - Country:US
Mailing Address - Phone:908-910-3713
Mailing Address - Fax:
Practice Address - Street 1:111 PARK PL
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1958
Practice Address - Country:US
Practice Address - Phone:908-910-3713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care