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General NPI Number Information
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NPI Number | 1841016144
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Entity Type | Organization
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Legal Business Name | LOVE COMMUNITY HOME CARE SERVICES LLC
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 112 MEADOWCREST DR
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City | BELLEVILLE
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State | IL
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Zip | 62221-6749
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Country | US
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Telephone | 618-550-6090
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Fax | 518-880-5027
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Provider Business Mailing Address
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Address Line | 112 MEADOWCREST DR
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City | BELLEVILLE
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State | IL
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Zip | 62221-6749
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Country | US
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Telephone | 618-550-6090
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Fax | 518-880-5027
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ORLANDO LAMONT LOVE JR.
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Credential |
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Telephone | 618-550-6090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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