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General NPI Number Information
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NPI Number | 1144649534
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Entity Type | Organization
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Legal Business Name | VIRTUES OF LOVE
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Dates
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Enumeration Date | 04/14/2014
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Last Update Date | 04/14/2014
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Provider Practice Location Address
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Address Line | 1000 S DAY ST APT 37
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City | BRENHAM
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State | TX
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Zip | 77833-4173
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Country | US
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Telephone | 301-213-6728
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 S DAY ST APT 37
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City | BRENHAM
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State | TX
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Zip | 77833-4173
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Country | US
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Telephone | 301-213-6728
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Fax |
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Authorized Official
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Title or Position | PROVIDER / PROGRAM MANAGER
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Name | AGATHA SHIPMAN
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Credential | C. E.O
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Telephone | 301-213-6728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State | TX
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