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General NPI Number Information
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NPI Number | 1447977350
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Entity Type | Organization
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Legal Business Name | LOVE COURAGE AND COMPASSION LLC
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Dates
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Enumeration Date | 10/21/2022
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Last Update Date | 10/21/2022
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Provider Practice Location Address
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Address Line | 1745 WELLS RD APT 103
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City | ORANGE PARK
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State | FL
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Zip | 32073-6717
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Country | US
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Telephone | 904-326-2032
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Fax | 904-664-4532
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Provider Business Mailing Address
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Address Line | 1745 WELLS RD APT 103
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City | ORANGE PARK
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State | FL
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Zip | 32073-6717
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Country | US
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Telephone | 904-326-2032
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Fax | 904-664-4532
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Authorized Official
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Title or Position | OWNER
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Name | QUANETTA MAE FARMER
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Credential |
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Telephone | 904-450-3624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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