Healthcare Provider Details

I. General information

NPI: 1790698488
Provider Name (Legal Business Name): LAGRACELOVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3906 REGENCY PKWY APT. 304
SUITLAND MD
20746
US

IV. Provider business mailing address

7375 EXECUTIVE PL STE 400
LANHAM MD
20706-6232
US

V. Phone/Fax

Practice location:
  • Phone: 240-870-9329
  • Fax:
Mailing address:
  • Phone: 240-870-9329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MS. TANYA ANNETTE EASON
Title or Position: OWNER
Credential:
Phone: 571-242-7419