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General NPI Number Information
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NPI Number | 1679012165
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Entity Type | Organization
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Legal Business Name | LIBERATING LOVE CO.
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Dates
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Enumeration Date | 02/16/2017
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Last Update Date | 02/16/2017
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Provider Practice Location Address
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Address Line | 8201 PETERS RD SUITE 1000-82
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City | PLANTATION
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State | FL
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Zip | 33324-3265
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Country | US
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Telephone | 888-608-1950
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Fax | 754-800-3902
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Provider Business Mailing Address
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Address Line | 8201 PETERS RD SUITE 1000-82
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City | PLANTATION
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State | FL
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Zip | 33324-3265
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Country | US
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Telephone | 888-608-1950
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Fax | 754-800-3902
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Authorized Official
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Title or Position | PRESIDENT/ ADMINISTRATOR
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Name | MS. GRACE LOVE
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Credential |
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Telephone | 888-608-1950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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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 | 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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