Healthcare Provider Details

I. General information

NPI: 1740949270
Provider Name (Legal Business Name): FIRST LOVE & CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2021
Last Update Date: 12/22/2023
Certification Date: 12/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 W CENTRAL AVE STE 211
WINTER HAVEN FL
33880-2977
US

IV. Provider business mailing address

6000 S FLORIDA AVE UNIT 7864
LAKELAND FL
33813-3320
US

V. Phone/Fax

Practice location:
  • Phone: 863-662-3019
  • Fax: 863-318-0695
Mailing address:
  • Phone: 863-662-3019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: JONNETRA BRITT
Title or Position: ADMINISTRATOR
Credential:
Phone: 863-662-3019