Provider Demographics
NPI:1780381723
Name:COMMUNITY LOVE COMPANIONSHIP INC
Entity type:Organization
Organization Name:COMMUNITY LOVE COMPANIONSHIP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-875-1790
Mailing Address - Street 1:15600 SW 70TH AVE
Mailing Address - Street 2:
Mailing Address - City:DUNNELLON
Mailing Address - State:FL
Mailing Address - Zip Code:34432-7468
Mailing Address - Country:US
Mailing Address - Phone:352-875-1790
Mailing Address - Fax:
Practice Address - Street 1:15600 SW 70TH AVE
Practice Address - Street 2:
Practice Address - City:DUNNELLON
Practice Address - State:FL
Practice Address - Zip Code:34432-7468
Practice Address - Country:US
Practice Address - Phone:352-875-1790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty