=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760992028
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LOVE LIKE OURS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/01/2017
-----------------------------------------------------
Last Update Date | 10/01/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 707 DARNEL DR
-----------------------------------------------------
City | MESQUITE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75149-5327
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-733-6525
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 707 DARNEL DR
-----------------------------------------------------
City | MESQUITE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75149-5327
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-733-6525
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | RN
-----------------------------------------------------
Name | MS. WHITNEY VILLA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 903-733-6525
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374T00000X
-----------------------------------------------------
Taxonomy Name | Religious Nonmedical Nursing Personnel
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 374U00000X
-----------------------------------------------------
Taxonomy Name | Home Health Aide
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------