Provider Demographics
NPI:1649004680
Name:LOVE LAWCD LLC
Entity type:Organization
Organization Name:LOVE LAWCD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DETRECE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAVENDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-565-0569
Mailing Address - Street 1:4904 YORK RD UNIT 4506
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-7501
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4359 NORTHVIEW DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-2603
Practice Address - Country:US
Practice Address - Phone:240-565-0569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty