Provider Demographics
NPI:1649956053
Name:LOVE YOURSELF RECOVERY
Entity type:Organization
Organization Name:LOVE YOURSELF RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARIAGNE ARIELLE
Authorized Official - Middle Name:ROGUE
Authorized Official - Last Name:DUAVE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:702-969-8785
Mailing Address - Street 1:1503 E CALVADA
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048
Mailing Address - Country:US
Mailing Address - Phone:702-969-8785
Mailing Address - Fax:
Practice Address - Street 1:1503 E CALVADA
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048
Practice Address - Country:US
Practice Address - Phone:702-969-8785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty