=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386814853
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LOVE TO LOVE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/11/2008
-----------------------------------------------------
Last Update Date | 06/13/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 218 OLD BASTROP RD
-----------------------------------------------------
City | MONROE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71203-4222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-855-6287
-----------------------------------------------------
Fax | 318-855-6288
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 218 OLD BASTROP RD
-----------------------------------------------------
City | MONROE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71203-4222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-855-6287
-----------------------------------------------------
Fax | 318-855-6288
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. ANNETTE HARRIS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 318-855-6287
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3747P1801X
-----------------------------------------------------
Taxonomy Name | Personal Care Attendant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------