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General NPI Number Information
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NPI Number | 1043088818
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Entity Type | Organization
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Legal Business Name | LOVE AND PEACE AGENCY LLC
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Dates
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Enumeration Date | 12/12/2023
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 23695 BLACKETT AVE
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City | WARREN
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State | MI
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Zip | 48089-4413
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Country | US
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Telephone | 734-496-4858
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Fax |
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Provider Business Mailing Address
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Address Line | 23695 BLACKETT AVE
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City | WARREN
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State | MI
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Zip | 48089-4413
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Country | US
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Telephone | 734-496-4858
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Fax |
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Authorized Official
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Title or Position | EX. DIRECTIOR
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Name | TINA R. WALKER
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Credential |
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Telephone | 734-496-4856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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