Provider Demographics
NPI:1013489244
Name:FAMILY LOVE 1X1
Entity Type:Organization
Organization Name:FAMILY LOVE 1X1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:RANA
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:RMA
Authorized Official - Phone:404-971-6374
Mailing Address - Street 1:814 BEECH VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-2526
Mailing Address - Country:US
Mailing Address - Phone:404-971-6374
Mailing Address - Fax:
Practice Address - Street 1:814 BEECH VALLEY RD
Practice Address - Street 2:
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-2526
Practice Address - Country:US
Practice Address - Phone:404-971-6374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-28
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care