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General NPI Number Information
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NPI Number | 1649956053
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Entity Type | Organization
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Legal Business Name | LOVE YOURSELF RECOVERY
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Dates
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Enumeration Date | 06/22/2023
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 1503 E CALVADA
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City | PAHRUMP
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State | NV
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Zip | 89048
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Country | US
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Telephone | 702-969-8785
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Fax |
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Provider Business Mailing Address
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Address Line | 1503 E CALVADA
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City | PAHRUMP
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State | NV
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Zip | 89048
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Country | US
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Telephone | 702-969-8785
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ARIAGNE ARIELLE ROGUE DUAVE
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Credential | RN
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Telephone | 702-969-8785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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