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General NPI Number Information
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NPI Number | 1982960555
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Entity Type | Organization
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Legal Business Name | LABOR OF LOVES LLC
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Dates
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Enumeration Date | 04/07/2012
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Last Update Date | 04/07/2012
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Provider Practice Location Address
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Address Line | 2194 GLENRIDGE RD
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City | EUCLID
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State | OH
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Zip | 44117-2439
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Country | US
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Telephone | 216-246-5153
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Fax |
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Provider Business Mailing Address
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Address Line | 2149 GLENRIDGE RD
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City | EUCLID
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State | OH
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Zip | 44117
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. DONNA MC MICKENS
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Credential |
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Telephone | 216-246-5153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State | OH
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