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General NPI Number Information
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NPI Number | 1780359232
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Entity Type | Organization
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Legal Business Name | LOVE LIVE AND GROW INC
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Dates
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Enumeration Date | 08/16/2021
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Last Update Date | 08/16/2021
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Provider Practice Location Address
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Address Line | 5843 FOREST HAVEN TRL
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City | DALLAS
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State | TX
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Zip | 75232-2501
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Country | US
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Telephone | 214-232-9305
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 382983
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City | DUNCANVILLE
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State | TX
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Zip | 75138-2983
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Country | US
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Telephone | 800-429-9551
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JANICE ADKISON
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Credential |
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Telephone | 214-232-9305
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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