Provider Demographics
NPI:1255075024
Name:LOVE WITH ME
Entity type:Organization
Organization Name:LOVE WITH ME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIAMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:313-695-0491
Mailing Address - Street 1:1970 E TROY ST
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-2070
Mailing Address - Country:US
Mailing Address - Phone:313-695-0491
Mailing Address - Fax:
Practice Address - Street 1:26150 5 MILE RD STE 22
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-3240
Practice Address - Country:US
Practice Address - Phone:586-482-8352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health