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NPI 1396499836

NPI 1396499836 : UNCONDITIONAL L0V3, LLC : AMERICAN FORK, UT

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General NPI Number Information
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    NPI Number           |    1396499836
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    Entity Type          |    Organization 
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    Legal Business Name  |    UNCONDITIONAL L0V3, LLC 
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Dates
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    Enumeration Date     |    02/03/2022
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    Last Update Date     |    02/03/2022
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Provider Practice Location Address
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    Address Line         |    134 N 300 E 
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    City                 |    AMERICAN FORK
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    State                |    UT
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    Zip                  |    84003-1745
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    Country              |    US
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    Telephone            |    424-240-4735
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    134 N 300 E 
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    City                 |    AMERICAN FORK
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    State                |    UT
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    Zip                  |    84003-1745
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    Country              |    US
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    Telephone            |    424-240-4735
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MRS. FLORENA  VAKI 
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    Credential           |    
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    Telephone            |    424-240-4735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    253J00000X
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    Taxonomy Name        |    Foster Care Agency
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    License Number       |    
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    License Number State |    
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