Provider Demographics
NPI:1801622667
Name:LOVE, NELSON ALEXANDER
Entity type:Individual
Prefix:
First Name:NELSON
Middle Name:ALEXANDER
Last Name:LOVE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1827 CORDOVA AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH COLLEGE HILL
Mailing Address - State:OH
Mailing Address - Zip Code:45239-4963
Mailing Address - Country:US
Mailing Address - Phone:513-410-5757
Mailing Address - Fax:
Practice Address - Street 1:1827 CORDOVA AVE
Practice Address - Street 2:
Practice Address - City:NORTH COLLEGE HILL
Practice Address - State:OH
Practice Address - Zip Code:45239-4963
Practice Address - Country:US
Practice Address - Phone:513-410-5757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services