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General NPI Number Information
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NPI Number | 1487319752
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Entity Type | Organization
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Legal Business Name | LOVE 4 LIFE LLC
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Dates
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Enumeration Date | 11/02/2021
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Last Update Date | 11/02/2021
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Provider Practice Location Address
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Address Line | 3032 N 6TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53212-1907
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Country | US
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Telephone | 414-739-8323
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Fax |
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Provider Business Mailing Address
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Address Line | 2359 N SHERMAN BLVD
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City | MILWAUKEE
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State | WI
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Zip | 53210-2945
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Country | US
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Telephone | 414-739-8323
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. JALONG M EVANS
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Credential |
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Telephone | 414-739-8323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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