Provider Demographics
NPI:1265046965
Name:LOVE ABUNDANTLY
Entity type:Organization
Organization Name:LOVE ABUNDANTLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:NENA
Authorized Official - Last Name:PARTEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-662-0320
Mailing Address - Street 1:8340 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63114-6238
Mailing Address - Country:US
Mailing Address - Phone:314-662-0320
Mailing Address - Fax:
Practice Address - Street 1:8340 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63114-6238
Practice Address - Country:US
Practice Address - Phone:314-662-0320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health