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General NPI Number Information
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NPI Number | 1588969950
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Entity Type | Organization
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Legal Business Name | L.O.V.E. COALITION
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Dates
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Enumeration Date | 01/17/2011
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Last Update Date | 01/17/2011
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Provider Practice Location Address
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Address Line | 3691 TAMPA TRL SW
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City | ATLANTA
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State | GA
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Zip | 30331-5307
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Country | US
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Telephone | 404-492-2632
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Fax |
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Provider Business Mailing Address
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Address Line | 3691 TAMPA TRL SW
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City | ATLANTA
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State | GA
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Zip | 30331-5307
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Country | US
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Telephone | 404-492-2632
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICIER
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Name | MR. EDSEL STEPHON COLLINS
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Credential | M.ED.
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Telephone | 404-492-2632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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