Healthcare Provider Details

I. General information

NPI: 1013146489
Provider Name (Legal Business Name): MORE LOVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 07/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3739 OVERLAND AVE
LOS ANGELES CA
90034-6311
US

IV. Provider business mailing address

212 19TH ST
SANTA MONICA CA
90402-2408
US

V. Phone/Fax

Practice location:
  • Phone: 310-815-9115
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number060000636
License Number StateCA

VIII. Authorized Official

Name: MRS. LINA ORLOV
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 310-702-3117