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General NPI Number Information
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NPI Number | 1831980432
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Entity Type | Organization
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Legal Business Name | LOVING LIFE AGAIN FOUNDATION
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 13751 EDWARDS ST APT 48A
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City | WESTMINSTER
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State | CA
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Zip | 92683-2961
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Country | US
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Telephone | 313-722-5602
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Fax |
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Provider Business Mailing Address
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Address Line | 13751 EDWARDS ST APT 48A
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City | WESTMINSTER
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State | CA
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Zip | 92683-2961
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Country | US
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Telephone | 313-722-5602
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Fax |
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Authorized Official
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Title or Position | FOUNDER & EXECUTIVE DIRECTOR
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Name | TYI'SHAUWN WATKINS
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Credential |
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Telephone | 313-722-5602
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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