Provider Demographics
NPI:1720727852
Name:LOVE CONQUERS ALL OUT-PATIENT SERVICES
Entity Type:Organization
Organization Name:LOVE CONQUERS ALL OUT-PATIENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:TONEY
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:704-299-3396
Mailing Address - Street 1:225 N CEDAR ST APT 119
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-3702
Mailing Address - Country:US
Mailing Address - Phone:704-299-3396
Mailing Address - Fax:
Practice Address - Street 1:225 N CEDAR ST APT 119
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-3702
Practice Address - Country:US
Practice Address - Phone:704-299-3396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty