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General NPI Number Information
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NPI Number | 1376886812
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Entity Type | Organization
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Legal Business Name | LOADS OF SMILES, LLC
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Dates
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Enumeration Date | 04/03/2013
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Last Update Date | 04/03/2013
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Provider Practice Location Address
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Address Line | 917 BEVILLE RD STE. G & H
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City | SOUTH DAYTONA
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State | FL
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Zip | 32119-1712
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Country | US
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Telephone | 386-788-0012
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Fax |
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Provider Business Mailing Address
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Address Line | 36 TOMOKA RIDGE WAY
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City | ORMOND BEACH
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State | FL
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Zip | 32174-1866
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Country | US
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Telephone | 386-663-2618
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINE BELZ
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Credential | RN
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Telephone | 386-663-2618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM3000X
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Taxonomy Name | Medically Fragile Infants and Children Day Care
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License Number | 60081002
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License Number State | FL
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