Healthcare Provider Details
I. General information
NPI: 1992954077
Provider Name (Legal Business Name): FOR THE LOVE OF LUCY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/15/2008
Last Update Date: 09/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6 RABURN RD
HUEYSVILLE KY
41640-6618
US
IV. Provider business mailing address
5255 HWY 160 SUITE A
LITTCARR KY
41834
US
V. Phone/Fax
- Phone: 169-679-1242
- Fax:
- Phone: 160-627-1242
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | KY |
VIII. Authorized Official
Name: MRS.
DANA
WHITE
SLONE
Title or Position: EXECUTIVE DIRECTOR/OWNER
Credential:
Phone: 16067912426