Provider Demographics
NPI:1992373534
Name:LIVE4LOVE INC
Entity Type:Organization
Organization Name:LIVE4LOVE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIERSTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-398-5887
Mailing Address - Street 1:3 WEST ST
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-2130
Mailing Address - Country:US
Mailing Address - Phone:717-398-5887
Mailing Address - Fax:
Practice Address - Street 1:3 WEST ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2130
Practice Address - Country:US
Practice Address - Phone:717-398-5887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0000546961OtherSAP VENDOR