Provider Demographics
NPI:1184241630
Name:GOOD SHEPHERD LOVING CARE, INC
Entity type:Organization
Organization Name:GOOD SHEPHERD LOVING CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:URMENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:954-822-2754
Mailing Address - Street 1:510 NW 98TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33150-1617
Mailing Address - Country:US
Mailing Address - Phone:954-822-2754
Mailing Address - Fax:
Practice Address - Street 1:510 NW 98TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-1617
Practice Address - Country:US
Practice Address - Phone:954-822-2754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)