=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124679931
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LOVIN TOUCH LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/23/2019
-----------------------------------------------------
Last Update Date | 09/23/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4130 W NORTHERN AVE
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85051-5765
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 623-440-1063
-----------------------------------------------------
Fax | 623-440-1064
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4130 W NORTHERN AVE
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85051-5765
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 623-440-1063
-----------------------------------------------------
Fax | 623-440-1064
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CAREGIVER
-----------------------------------------------------
Name | GELU ISFANUT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 623-440-1063
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 311ZA0620X
-----------------------------------------------------
Taxonomy Name | Adult Care Home Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------