Healthcare Provider Details

I. General information

NPI: 1154059657
Provider Name (Legal Business Name): LOVE BEYOND WORDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2022
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14516 TACUBA DR
LA MIRADA CA
90638-2043
US

IV. Provider business mailing address

17906 CANEHILL AVE
BELLFLOWER CA
90706-7149
US

V. Phone/Fax

Practice location:
  • Phone: 562-805-0526
  • Fax: 562-685-0523
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: DEBRA BALLOU-HARDING
Title or Position: OWNER
Credential:
Phone: 310-650-0545