Provider Demographics
NPI:1952758567
Name:BELOVED1 LLC
Entity Type:Organization
Organization Name:BELOVED1 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EBERECHI
Authorized Official - Middle Name:CORNELIA
Authorized Official - Last Name:EKECHUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-334-6621
Mailing Address - Street 1:15471 PAPILLON PL
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-3399
Mailing Address - Country:US
Mailing Address - Phone:703-334-6621
Mailing Address - Fax:703-334-6615
Practice Address - Street 1:15471 PAPILLON PL
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-3399
Practice Address - Country:US
Practice Address - Phone:703-334-6621
Practice Address - Fax:703-334-6615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-24
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care