Provider Demographics
NPI:1801319272
Name:BRENYA'S LOVE LLC
Entity type:Organization
Organization Name:BRENYA'S LOVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PETRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONWUEMELI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-262-0720
Mailing Address - Street 1:2050 S RIDGEWOOD AVE APT S8
Mailing Address - Street 2:
Mailing Address - City:SOUTH DAYTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32119-8423
Mailing Address - Country:US
Mailing Address - Phone:386-262-0720
Mailing Address - Fax:
Practice Address - Street 1:2050 S RIDGEWOOD AVE APT S8
Practice Address - Street 2:
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-8423
Practice Address - Country:US
Practice Address - Phone:386-262-0720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X, 372500000X
FL376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty