Healthcare Provider Details

I. General information

NPI: 1669068474
Provider Name (Legal Business Name): GOD'S LOVING ARMS RETREAT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2020
Last Update Date: 03/15/2021
Certification Date: 03/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1179 GREYSTONE PKWY
TOLEDO OH
43615-7674
US

IV. Provider business mailing address

1179 GREYSTONE PKWY
TOLEDO OH
43615-7674
US

V. Phone/Fax

Practice location:
  • Phone: 567-277-3852
  • Fax:
Mailing address:
  • Phone: 567-277-3852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: UNA LOVE
Title or Position: OWNER
Credential:
Phone: 567-277-3852