Healthcare Provider Details

I. General information

NPI: 1093456428
Provider Name (Legal Business Name): LOVE AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2022
Last Update Date: 04/07/2022
Certification Date: 04/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 3RD ST NE OFC 2038
WASHINGTON DC
20002-6274
US

IV. Provider business mailing address

1140 3RD ST NE OFC 2038
WASHINGTON DC
20002-6274
US

V. Phone/Fax

Practice location:
  • Phone: 510-605-2795
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: ELISABETH NGUTY NKENG
Title or Position: OWNER/ CEO
Credential:
Phone: 510-605-2795