Provider Demographics
NPI:1649952136
Name:LOVE FAMILY SERVICES
Entity type:Organization
Organization Name:LOVE FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAVODKA
Authorized Official - Middle Name:LOVE
Authorized Official - Last Name:NOWACKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:828-443-8415
Mailing Address - Street 1:3518 HERMAN SIPE RD NW
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-8903
Mailing Address - Country:US
Mailing Address - Phone:828-443-8415
Mailing Address - Fax:
Practice Address - Street 1:3518 HERMAN SIPE RD NW
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-8903
Practice Address - Country:US
Practice Address - Phone:828-443-8415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency