Provider Demographics
NPI:1831724434
Name:LOVE VILLAGE USA, INC.
Entity type:Organization
Organization Name:LOVE VILLAGE USA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:LINA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:GAVIRIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-371-3893
Mailing Address - Street 1:3241 SW 117TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3153
Mailing Address - Country:US
Mailing Address - Phone:786-803-8606
Mailing Address - Fax:786-513-8062
Practice Address - Street 1:3241 SW 117TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3153
Practice Address - Country:US
Practice Address - Phone:786-803-8606
Practice Address - Fax:786-513-8062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility