MEDICARE: LOVE LIFE FAMILY SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	251S00000X	Community/Behavioral Health Agency
3	253Z00000X	In Home Supportive Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215683024
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVE LIFE FAMILY SERVICES LLC

Provider Business Mailing Address
First Line	:	1633 GRAPE AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63147-1405
Country	:	US
Telephone Number	:	314-240-2944
Fax Number	:

Provider Business Practice Location Address
First Line	:	1633 GRAPE AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63147-1405
Country	:	US
Telephone Number	:	314-240-2944
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	RHONISHA LOUIS
Credential	:
Telephone Number	:	314-240-2944

Provider Enumeration Date	:	03/02/2022
Last Update Date	:	03/02/2022

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Directions to “LOVE LIFE FAMILY SERVICES LLC ” Practice Location

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