Healthcare Provider Details

I. General information

NPI: 1699117416
Provider Name (Legal Business Name): ILOVEKARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2013
Last Update Date: 10/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 CREEL CHASE NW
KENNESAW GA
30144-5089
US

IV. Provider business mailing address

216 CREEL CHASE NW
KENNESAW GA
30144-5089
US

V. Phone/Fax

Practice location:
  • Phone: 404-692-0539
  • Fax:
Mailing address:
  • Phone: 404-692-0539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KIMBERLY MICHELLE HAASE
Title or Position: OWNER
Credential:
Phone: 404-692-0539