Healthcare Provider Details

I. General information

NPI: 1912432014
Provider Name (Legal Business Name): LOVE FOR LIFE AT HOME SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2017
Last Update Date: 04/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

283 LISBON AVE UPPER
BUFFALO NY
14215-1027
US

IV. Provider business mailing address

283 LISBON AVE UPPER
BUFFALO NY
14215-1027
US

V. Phone/Fax

Practice location:
  • Phone: 716-548-9699
  • Fax: 888-879-0325
Mailing address:
  • Phone: 716-548-9699
  • Fax: 888-879-0325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. SHANESHA J CAVER
Title or Position: PRESIDENT
Credential:
Phone: 716-548-9699