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General NPI Number Information
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NPI Number | 1861134876
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Entity Type | Organization
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Legal Business Name | LOVE WINS COMMUNITY CARE
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Dates
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Enumeration Date | 04/11/2022
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Last Update Date | 04/11/2022
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Provider Practice Location Address
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Address Line | 2401 FOUNTAIN VIEW DRIVE SUITE 312 PMB2526
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City | HOUSTON
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State | TX
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Zip | 77057-7705
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Country | US
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Telephone | 919-279-8551
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Fax |
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Provider Business Mailing Address
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Address Line | 65 E WALKER WOODS LN
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City | CLAYTON
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State | NC
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Zip | 27527-6902
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Country | US
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Telephone | 919-279-8551
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RENEE JONES
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Credential |
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Telephone | 919-279-8551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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