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General NPI Number Information
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NPI Number | 1063203347
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Entity Type | Organization
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Legal Business Name | PEACE LOVE WELLNESS HEALTH SYSTEM
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 636 GAUSE BLVD
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City | SLIDELL
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State | LA
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Zip | 70458-2007
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Country | US
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Telephone | 985-260-1999
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Fax |
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Provider Business Mailing Address
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Address Line | 636 GAUSE BLVD
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City | SLIDELL
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State | LA
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Zip | 70458-2007
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Country | US
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Telephone | 985-260-1999
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Fax |
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Authorized Official
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Title or Position | NATUROPATHIC PRACTITIONER
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Name | LAKENDRA RILEY
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Credential | ND
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Telephone | 985-260-1999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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