Healthcare Provider Details

I. General information

NPI: 1962864702
Provider Name (Legal Business Name): LOVING YOU THROUGH IT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 03/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15365 HIGHWAY 80
MINDEN LA
71055-6367
US

IV. Provider business mailing address

15365 HIGHWAY 80
MINDEN LA
71055-6367
US

V. Phone/Fax

Practice location:
  • Phone: 318-268-8077
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number2368397
License Number StateLA

VIII. Authorized Official

Name: KIMBERLY WESTON
Title or Position: PROGRAM MANAGER
Credential:
Phone: 318-268-8077