Healthcare Provider Details

I. General information

NPI: 1841543915
Provider Name (Legal Business Name): LOVEJOY FAITH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2012
Last Update Date: 10/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12034 GREEN GLADE DR
HOUSTON TX
77099-3220
US

IV. Provider business mailing address

12034 GREEN GLADE DR
HOUSTON TX
77099-3220
US

V. Phone/Fax

Practice location:
  • Phone: 832-421-0814
  • Fax: 281-861-4706
Mailing address:
  • Phone: 832-421-0814
  • Fax: 281-861-4706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: TAMMY LYNN HANCHETT
Title or Position: OWNER
Credential:
Phone: 832-421-0814