Provider Demographics
NPI:1669972105
Name:LOVED-ONES AGAINST METH MINISTRIES
Entity type:Organization
Organization Name:LOVED-ONES AGAINST METH MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONITA
Authorized Official - Middle Name:E
Authorized Official - Last Name:DAVENPORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-545-1641
Mailing Address - Street 1:1020 9TH ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-1119
Mailing Address - Country:US
Mailing Address - Phone:970-978-4016
Mailing Address - Fax:970-515-5091
Practice Address - Street 1:1020 9TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-1119
Practice Address - Country:US
Practice Address - Phone:970-978-4016
Practice Address - Fax:970-515-5091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility